Individual provider Active NPI

Jaqueline M Worth, MD

  • Obstetrics Physician
  • New York, NY
National Provider Identifier
1619971975
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
211448 Issued in NY
Practice address
1225 Park Ave Ste 1D
New York, NY 10128-1758
Phone
(212) 741-2229
Fax
(212) 741-2228
NPI assigned
Jun 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X 211448 NY Primary
Obstetrics & Gynecology Physician 207V00000X 211448 NY

Addresses

Primary practice location

1225 Park Ave Ste 1D
New York, NY 10128-1758

Mailing address

1225 Park Ave
Suite 1D
New York, NY 10128-1758
Phone (212) 741-2229

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
I20040427001759 NY Practitioner - Obstetrics/Gynecology 9739176181 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211448NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maternity Medical Group PLLC Obstetrics & Gynecology Current Accepting new patients
Village Maternity Physicians, PLLC Obstetrics Current Accepting new patients
Village Obstetrics, LLC Obstetrics & Gynecology Current Accepting new patients
Bronxcare Health System Current Accepting new patients
Elj Obstetrics & Gynecology Group, PLLC Past Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Networks

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

Interoperability endpoints

  • Direct secure messaging: jworth1233168@nychhc.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BBHACD/Endpoint/BBHACD

Organizations & group practices 5

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": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1619971975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 PARK AVE",
            "address_2": "SUITE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281758",
            "telephone_number": "212-741-2229",
            "fax_number": "212-741-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 PARK AVE STE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281758",
            "telephone_number": "212-741-2229",
            "fax_number": "212-741-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTH",
        "first_name": "JAQUELINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "211448",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "211448",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.