Individual provider Active NPI

Jamie Sklar, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Babylon, NY
National Provider Identifier
1609239367
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
300602-01 Issued in NY
Practice address
655 Deer Park Ave.
Babylon, NY 11702
Phone
(631) 321-2100
Fax
(631) 321-2125
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Developmental - Behavioral Pediatrics Physician 2080P0006X 300602-01 NY Primary
Pediatrics Physician 208000000X 300602-01 NY

Addresses

Primary practice location

655 Deer Park Ave.
Babylon, NY 11702

Mailing address

655 Deer Park Ave.
Babylon, NY 11702
Phone (631) 321-2100

Other practice location 1

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200424002718 NY Practitioner - Pediatric MedicinePractitioner - Internal Medicine 5395175723 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
300602NYMDLicensed Practical Nurse
300602-01NYMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Dec 6, 2022 Accepting new patients
Samaritan Pediatric Services, P.C. Pediatrics CurrentSince Dec 1, 2022 Accepting new patients

Locations

655 Deer Park Ave
Babylon, NY 11702
Phone (631) 321-2100

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1983 Marcus Ave
Ste 130
New Hyde Park, NY 11042
Phone (516) 802-6100

300 Community Dr
Plandome, NY 11030

2000 N Village Ave
Ste 310
Rockville Ctr, NY 11570
Phone (516) 536-2211

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: jsklar147649@direct-chsli.net

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1609239367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 DEER PARK AVE.",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "11702",
            "telephone_number": "631-321-2100",
            "fax_number": "631-321-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 DEER PARK AVE.",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "11702",
            "telephone_number": "631-321-2100",
            "fax_number": "631-321-2125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "516-562-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKLAR",
        "first_name": "JAMIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2023-11-27",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "300602-01",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "300602-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

Verify at the official NPI Registry.