Individual provider Active NPI

Beena E Jacob, FNP-BC

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1780249870
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F344333 Issued in NY
Practice address
10 E 102ND St
New York, NY 10029-6030
Phone
(212) 241-5656
Fax
(212) 241-8866
NPI assigned
May 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F344333 NY Primary

Addresses

Primary practice location

10 E 102ND St
New York, NY 10029-6030

Mailing address

150 E 42ND St FL 9
New York, NY 10017-5699
Phone (646) 605-8186

Other practice location 1

10 Union Sq E
New York, NY 10003-3314
Phone (212) 420-2377

Other practice location 2

1 Gustave L Levy Pl Fl 12
New York, NY 10029-6574
Phone (212) 241-5900

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191213001181 NY Practitioner - Nurse Practitioner 3971936402 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F344333NYMDFamily Nurse Practitioner

Practice roles (6 of 10)

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Memorial Anesthesiology Group CurrentSince Jun 20, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai PastSince Nov 24, 2019 Accepting new patients
Bimc Faculty Practice PastSince Nov 24, 2019 Accepting new patients

Locations

200 Old Country Rd
Mineola, NY 11501
Phone (516) 408-4900

150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

10 E 102nd St
New York, NY 10029
Phone (212) 241-5656

1 Gustave L Levy Pl
Fl 12
New York, NY 10029
Phone (212) 241-1518

10 Union Sq E
New York, NY 10003
Phone (212) 253-6800

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1557014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1780249870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E 42ND ST FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100175699",
            "telephone_number": "646-605-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E 102ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296030",
            "telephone_number": "212-241-5656",
            "fax_number": "212-241-8866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Union Sq E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100033314",
            "country_code": "US",
            "telephone_number": "212-420-2377",
            "fax_number": "212-420-4684",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Gustave L Levy Pl Fl 12",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296574",
            "country_code": "US",
            "telephone_number": "212-241-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "BEENA",
        "middle_name": "E",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-05",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F344333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.