Active NPI
Jacob Sjirk Saslow, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Syracuse, NY
National Provider Identifier
1760869408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- F403586
- Practice address
- 1045 James St
Syracuse, NY 13203-2730 - Phone
- (315) 530-2290
- NPI assigned
- May 1, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 008076-1 | NY | |
| Mental Health Counselor | 101YM0800X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F403586 | NY | Primary |
Addresses
Primary practice location
1045 James St
Syracuse, NY 13203-2730
Mailing address
1045 James St
Syracuse, NY 13203-2730
Phone (315) 530-2290
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008076-1 | NY | MD | Community Health Worker |
| F403586 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liberty Resources Inc. | Current | Accepting new patients | |
| Liberty Resources, Inc. | Current | Accepting new patients | |
| Liberty Resources, Inc. | Current | Accepting new patients |
Locations
1045 James St
Syracuse, NY 13203
Phone (315) 425-1004
Interoperability endpoints
- jacob.saslow.p1@direct.liberty-resources.nextgenshare.com
Organizations & group practices 3
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Syracuse, NY
- NPI 1225254881
-
- Federally Qualified Health Center (FQHC)
- Fulton, NY
- NPI 1700688827
-
- Primary Care Clinic/Center
- Syracuse, NY
- NPI 1821485483
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631059200000",
"number": "1760869408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 JAMES ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132032730",
"telephone_number": "315-530-2290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 JAMES ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132032730",
"telephone_number": "315-530-2290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SASLOW",
"first_name": "JACOB",
"middle_name": "SJIRK",
"credential": "PMHNP-BC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-01",
"last_updated": "2021-09-08",
"certification_date": "2021-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "008076-1",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "F403586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.