Individual provider Active NPI

Louis W Jacobs, DPM

  • Podiatrist
  • Bronx, NY
National Provider Identifier
1700062999
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2380 Issued in NY
Practice address
4240 Hutchinson River Pkwy E
4240 Hutchinson River Pkwy East
Bronx, NY 10475-4746
Phone
(718) 671-2233
Fax
(718) 671-2323
NPI assigned
Jan 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2380 NY Primary

Addresses

Primary practice location

4240 Hutchinson River Pkwy E
4240 Hutchinson River Pkwy East
Bronx, NY 10475-4746

Mailing address

4240 Hutchinson River Pkwy E
4240 Hutchinson River Pkwy East
Bronx, NY 10475-4746
Phone (718) 671-2233

Other identifiers 1

IdentifierTypeStateIssuer
00413438MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2380NYMDPodiatrist
002380NYMDMusic Therapist

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1700062999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 HUTCHINSON RIVER PKWY E",
            "address_2": "4240 HUTCHINSON RIVER PKWY EAST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754746",
            "telephone_number": "718-671-2233",
            "fax_number": "718-671-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 HUTCHINSON RIVER PKWY E",
            "address_2": "4240 HUTCHINSON RIVER PKWY EAST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104754746",
            "telephone_number": "718-671-2233",
            "fax_number": "718-671-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "LOUIS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "2380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00413438",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.