Harry Jay Jaffe, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Practice address

1713 Central Street
Evanston, IL 60201-1507

Phone

(847) 475-8888

Fax

(847) 869-2932

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2014 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629180450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 CENTRAL STREET",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011507",
            "telephone_number": "847-475-8888",
            "fax_number": "847-869-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 CENTRAL STREET",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011507",
            "telephone_number": "847-475-8888",
            "fax_number": "847-869-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFE",
        "first_name": "HARRY",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Jacobs, PH.D.
• Jonker Casper Jacobs, DMD
• Kelly Marie Jacobs, LCSW, PMH-C
• Andrew Jaeger, MD
• Arshia Jafar Nia, DMD
• Marla Jaffe, OTR/L
• Mubasher Jaffri, DO
• Peter Loren Jaggard, MD
• Shana Sunder Jagwani, MD
• Rajat Kumar Jain, M.D.

• Internal Medicine Physician in Evanston, IL
• Providers in Evanston, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.