Jacob Joseph Kalarickal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1610051 Issued in NY

Practice address

1210 Webster Ave
Bronx, NY 10456-4208

Phone

(646) 612-7747

NPI assigned

Sep 29, 2021

Sex

Male

Sole proprietor

Yes

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, NJ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Divinity Medical Services PLLC

  • Urgent Care Clinic/Center
  • Yorktown Heights, NY
  • NPI 1497159560
  Medicare reassignment
• DRX Paramus, LLC

  • Urgent Care Clinic/Center
  • Paramus, NJ
  • NPI 1316272685
  Medicare reassignment
• Njucare LLC

  • Clinic/Center
  • Roselle Park, NJ
  • NPI 1598455529
  NPD (past)

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1790457679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 WEBSTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564208",
            "telephone_number": "973-997-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 WEBSTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104564208",
            "telephone_number": "646-612-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALARICKAL",
        "first_name": "JACOB",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1610051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Olga Kalafatic, MD
• William Edward Kalafatic, M.D.
• William H Kalafatic, MD
• Lobina Kaniz Kalam, M.D.
• Sonya Kalani
• Giulia Kalavritinos
• Paul Christopher Kalaydjian, CRPA-P
• Linda Susan Kalb-Schweitzer, LCSW
• Elizabeth Kaledzi, RNP
• Muhammad Ahmed Kaleem

• Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.

Verify at the official NPI Registry.