Jackie Jian, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

315129 Issued in NY

Practice address

506 6TH St
Brooklyn, NY 11215-3609

Phone

(718) 780-3137

NPI assigned

Apr 5, 2018

Last updated

Jul 20, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NY, PA2 enrollments

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 2

Specialty

Emergency Medicine

Education

New York College of Osteo Medicine of New York Institute of Technology, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Corning HospitalGroup PAC ID 9133031925, 42 clinicians

Robert Packer HospitalGroup PAC ID 8022915180, shared by 5 NPIs, 53 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Packer Hospital Hospital, Sayre, PA, CCN 390079
• Corning Hospital Hospital, Corning, NY, CCN 330277

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjian187930@direct-guthrie.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Corning Hospital

  • General Acute Care Hospital
  • Corning, NY
  • NPI 1346241973

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Kings Physician Services, PC

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1083045090
  Medicare reassignment NPD
• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Medicare reassignment NPD
• Robert Packer Hospital

  dba Robert Packer Hospital, Towanda Campus

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Medicare reassignment NPD
• Troy Community Hospital Incorporated

  • Critical Access Hospital
  • Troy, PA
  • NPI 1306847926
  Medicare reassignment NPD
• Corning Hospital

  dba Corning Hospital Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Corning, NY
  • NPI 1962010694
  NPD
• Kings Physician Services, PC

  dba Kings Emergency Physician Services

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1326698879
  NPD
• Robert Packer Hospital

  dba Guthrie EMS

  • Land Ambulance
  • Towanda, PA
  • NPI 1568063782
  NPD (past)

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

• Corning Hospital

  • General Acute Care Hospital
  • Corning, NY
  • NPI 1346241973
  Care Compare affiliation
• Robert Packer Hospital

  • General Acute Care Hospital
  • Sayre, PA
  • NPI 1083614382
  Care Compare affiliation
• Robert Packer Hospital

  dba Robert Packer Hospital, Towanda Campus

  • General Acute Care Hospital
  • Towanda, PA
  • NPI 1134734528
  Care Compare affiliation

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1770089864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10336 118TH ST # 2F",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191920",
            "telephone_number": "917-254-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 6TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153609",
            "telephone_number": "718-780-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIAN",
        "first_name": "JACKIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "315129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Changping Jia, MD
• Jingqi Jia
• Karen Y Jia, MD
• Tianyu Jia
• Kamanie Jialal, MSED
• Jiang Acupuncture Wellness P.C.
• Jianqiu Jiang, L.AC
• Johnny Jiang
• Li Yan Jiang
• Lindie Jiang, PA-C

• Emergency Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.