Jesse Hackell, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

145137 Issued in NY

Practice address

4 Medical Park Dr
Suite C
Pomona, NY 10970-3516

Phone

(845) 362-0202

Fax

(845) 362-1347

NPI assigned

Oct 12, 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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Boston Children'S Health Physicians, LLP

  • Pediatrics Physician
  • Hawthorne, NY
  • NPI 1467454967
  Medicare reassignment NPD
• Boston Childrens Health Physicians LLP

  • Clinical Medical Laboratory
  • Sleepy Hollow, NY
  • NPI 1588651079
  NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730278185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEDICAL PARK DR",
            "address_2": "SUITE C",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703516",
            "telephone_number": "845-362-0202",
            "fax_number": "845-362-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEDICAL PARK DR",
            "address_2": "SUITE C",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703516",
            "telephone_number": "845-362-0202",
            "fax_number": "845-362-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKELL",
        "first_name": "JESSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "145137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00606253",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven C Greene, DMD
• Devora Grossman, O.D.
• Tova Grumet, M.A. CCC-SLP
• Jasmin Guisao
• Maurice Haberman, MD
• Edward George Hall, MEDICAL DOCTOR
• Kim Marie Hallinan, NP
• Richard E. Handelsman, DO
• Health Psychiatry of New York PC
• Healthful Nutrition Services PLLC

• Pediatrics Physician in Pomona, NY
• Providers in Pomona, NY by specialty
• Pediatrics Physician in New York

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.