Jacky Salomon Petion, DR.

Primary specialty

Behavioral Neurology & Neuropsychiatry PhysicianTaxonomy code 2084B0040X

License

1026480 Issued in MA

Practice address

1 Brookdale PLZ, Brooklyn
Brooklyn, NY 11212-3139

Phone

(718) 613-4334

NPI assigned

May 27, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Interborough Developmental and Consultation Center IncGroup PAC ID 7911898192, 167 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brookdale Hospital Medical Center Hospital, Brooklyn, NY, CCN 330233

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Interborough Developmental and Consultation Center, Inc.

  • Case Management Agency
  • Brooklyn, NY
  • NPI 1588611842
  Medicare reassignment Care Compare group NPD
• Interborough Developmental and Consultation Center, Inc.

  • Multi-Specialty Clinic/Center
  • Brooklyn, NY
  • NPI 1912867433
  NPD

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

• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1346380870
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1356307656
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1487724712
  Care Compare affiliation
• The Brookdale Hospital Medical Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1639756406

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1700525854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 FENWOOD RD FL 9",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156128",
            "telephone_number": "781-416-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ, BROOKLYN",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-613-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETION",
        "first_name": "JACKY",
        "middle_name": "SALOMON",
        "credential": "DR.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-27",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "MA",
            "license": "1026480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK ID",
            "identifier": "16241951562491",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen J Peterson, M.D.
• Sydney M Peterson
• Tamia Peterson
• Vanessa Anne Petgrave, CNM
• Lisa Petillo, PHD, LCSW
• Jean Petion
• Josseline Petion
• Queena Petion
• Roudeline Petion
• Kelly Petit Frere

• Behavioral Neurology & Neuropsychiatry Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Behavioral Neurology & Neuropsychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.