Individual provider Active NPI

Joel Ackelsberg

  • Infectious Disease Physician
  • Long Island City, NY
National Provider Identifier
1669873402
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
217352 Issued in NY
Practice address
4209 28TH St # CN-22a
Long Island City, NY 11101-4130
Phone
(347) 396-2645
Fax
(347) 396-2753
NPI assigned
Sep 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 217352 NY Primary

Addresses

Primary practice location

4209 28TH St # CN-22a
Long Island City, NY 11101-4130

Mailing address

4209 28TH St # CN-22a
Long Island City, NY 11101-4130
Phone (347) 396-2645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
217352NYMDInfectious Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1669873402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 28TH ST # CN-22A",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014130",
            "telephone_number": "347-396-2645",
            "fax_number": "347-396-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 28TH ST # CN-22A",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111014130",
            "telephone_number": "347-396-2645",
            "fax_number": "347-396-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKELSBERG",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-11",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "217352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.