Nicola Joseph Jacobucci, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

296566 Issued in NY

Practice address

418-420 5TH Avenue
Brooklyn, NY 11215

Phone

(718) 965-2273

Fax

(718) 965-2275

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

State licenses

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.

• Wake Forest Health Network LLC

  dba Atrium Health Wake Forest Baptist Pediatrics - Greensboro

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1477785756
  Medicare reassignment NPD
• City Medical of Upper East Side, PLLC

  dba CityMD Urgent Care

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1609148733
  NPD
• Cornerstone Health Care LLC

  dba Ford, Simpson, Lively and Rice Pediatrics @ Kville

  • Pediatrics Physician
  • Kernersville, NC
  • NPI 1316382559
  NPD
• Wake Forest Health Network, LLC

  dba Atrium Health Levine Children's Pediatrics Northwest

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1053175299
  NPD
• Cornerstone Health Care PA

  • Cardiovascular Disease Physician
  • Statesville, NC
  • NPI 1275914046
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1780617639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418-420 5TH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11215",
            "telephone_number": "718-965-2273",
            "fax_number": "718-965-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBUCCI",
        "first_name": "NICOLA",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "97-01772",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "296566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Jacobson
• Rachel M Jacobson, MS
• Shifra Jacobson
• Tanya Jacobson, O.D.
• Zakai Jacobson, DDS
• Alexandra D. Jacobus, LCSW
• Judith Jacoby, LMSW
• Kelsey Jacoby, LMSW
• Laurian Jacoby, MD
• Rachel L Jacoby

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; 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.