Active NPI
Jacob Cole Jackson, M.D.
- Anesthesiology Physician
- New York, NY
National Provider Identifier
1588907240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 288525
- Practice address
- 525 E 68TH St
Box 124
New York, NY 10065-4870 - Phone
- (212) 746-2959
- Fax
- (212) 746-8563
- NPI assigned
- Apr 1, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 25MA10388000 | NJ | |
| Anesthesiology Physician | 207L00000X | 288525 | NY | Primary |
Addresses
Primary practice location
525 E 68TH St
Box 124
New York, NY 10065-4870
Mailing address
525 E 68TH St
Box 124
New York, NY 10065-4870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000
480 Red Hill Rd
Middletown, NJ 07748-3052
Phone (908) 542-3007
650 Commack Rd
Commack, NY 11725-5404
Phone (631) 623-4034
Hospital & facility affiliations
- Memorial Hospital for Cancer and Allied Diseases
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.79 of 100
- Quality
- 80.63
- Improvement activities
- 40
- Cost
- 49.95
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA10388000 | NJ | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Affiliate Group of New York PC | Multi-Specialty | Current | Accepting new patients |
| MSK Monmouth | Multi-Specialty | Current | Accepting new patients |
| Mskcc Regional Network | Multi-Specialty | Current | Accepting new patients |
| Memorial Anesthesiology Group | Multi-Specialty | Current | Accepting new patients |
Locations
2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354
650 Commack Rd
Commack, NY 11725
Phone (631) 623-4000
506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000
633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764
1275 York Ave
New York, NY 10065
Phone (212) 639-3813
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
Interoperability endpoints
- jjackson4368793@nychhc.direct-ci.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
Multi-Specialty
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New York, NY
- NPI 1700887411
-
- Special Hospital
- New York, NY
- NPI 1770046351
-
- General Acute Care Hospital
- Basking Ridge, NJ
- NPI 1659385474
-
- General Acute Care Hospital
- Montvale, NJ
- NPI 1841650330
-
- General Acute Care Hospital
- Middletown, NJ
- NPI 1528428521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749686400000",
"number": "1588907240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 E 68TH ST",
"address_2": "BOX 124",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100654870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 E 68TH ST",
"address_2": "BOX 124",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100654870",
"telephone_number": "212-746-2959",
"fax_number": "212-746-8563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "JACOB",
"middle_name": "COLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-01",
"last_updated": "2025-06-12",
"certification_date": "2025-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MA10388000",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": "NY",
"license": "288525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.