Individual provider Active NPI

Jacob Carl Rouse, MD

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1871680967
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
236542 Issued in NY
Practice address
525 E 68TH St Ste A1014
New York, NY 10021-4870
Phone
(212) 746-2790
Fax
(212) 746-8108
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 236542 NY Primary

Addresses

Primary practice location

525 E 68TH St Ste A1014
New York, NY 10021-4870

Mailing address

525 E 68TH St Ste A1014
New York, NY 10021-4870
Phone (212) 746-0373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 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

Enrollment IDStateProvider typePAC IDDetails
I20050819000590 NY Practitioner - Anesthesiology 1254361116 Reassigns benefits to 1 organization
I20201202002095 CT Practitioner - Anesthesiology 1254361116 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Oregon Health Sciences University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians

Practice addresses (Care Compare)

195 E Main St
Huntington, NY 11743-2957
Phone (914) 666-8866

40 Old Ridgebury Rd
Danbury, CT 06810-5119
Phone (203) 205-2840

Hospital & facility affiliations

  • Northern Westchester Hospital Hospital, Mount Kisco, NY, CCN 330162

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Apr 15, 2019 Accepting new patients
North Shore - Lij Anesthesiology, PC Anesthesiology CurrentSince Mar 31, 2020 Accepting new patients
Weill Medical College of Cornell Past Accepting new patients
Mount Kisco Medical Group PastSince Apr 15, 2019 Accepting new patients

Locations

40 Old Ridgebury Rd
Danbury, CT 06810
Phone (203) 205-2840

644 Stoneleigh Ave
Carmel, NY 10512

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

60 Goldens Bridge Rd
Katonah, NY 10536
Phone (914) 232-1919

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

Networks

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

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1871680967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST STE A1014",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214870",
            "telephone_number": "212-746-0373",
            "fax_number": "212-746-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST STE A1014",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214870",
            "telephone_number": "212-746-2790",
            "fax_number": "212-746-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSE",
        "first_name": "JACOB",
        "middle_name": "CARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "236542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.