Individual provider Active NPI

Jackson Runte, MD

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1609453430
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
200714 Issued in CA
Practice address
1468 Madison Ave
New York, NY 10029-6508
Phone
(212) 241-6500
NPI assigned
Mar 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 200714 CA Primary

Addresses

Primary practice location

1468 Madison Ave
New York, NY 10029-6508

Mailing address

18050 Calle Oeste Rd
Sonora, CA 95370-8733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250924002977 CA Practitioner - Emergency Medicine 4486159126 Reassigns benefits to 1 organization
I20251001000127 TX Practitioner - Emergency Medicine 4486159126 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, San Francisco School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HMH Emergency Medical Group, Inc.Group PAC ID 7911800826, 56 clinicians

Practice addresses (Care Compare)

100 W California Blvd
Pasadena, CA 91105-3010
Phone 6264470296142

Hospital & facility affiliations

  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438
  • Chinle Comprehensive Health Care Facility Hospital, Chinle, AZ, CCN 030084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200714CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Chinle Comprehensive CurrentSince Sep 3, 2025 Accepting new patients
HMH Emergency Medical Group, Inc. Emergency Medicine CurrentSince Jul 12, 2025 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility Current Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Sep 3, 2025 Accepting new patients
Huntington Memorial Hospital Past Accepting new patients

Locations

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1609453430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18050 CALLE OESTE RD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953708733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNTE",
        "first_name": "JACKSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "200714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.