NPIMap

Individual provider Active NPI

Jordan M.S. Jacobs, M.D.

  • Plastic Surgery Physician
  • Tarrytown, NY
National Provider Identifier
1881852564
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
248057 Issued in NY
Practice address
155 White Plains Rd
Suite 109
Tarrytown, NY 10591-5523
Phone
(914) 366-6139
Fax
(866) 780-6139
NPI assigned
May 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 248057 NY Primary

Addresses

Primary practice location

155 White Plains Rd
Suite 109
Tarrytown, NY 10591-5523

Mailing address

155 White Plains Rd
Suite 109
Tarrytown, NY 10591-5523

Other identifiers 1

IdentifierTypeStateIssuer
03466075MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120927000552 NY Practitioner - Plastic and Reconstructive Surgery 8325297880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

5 E 98TH St
Surgery Dept
New York, NY 10029-6501
Phone (212) 241-6591

Hospital & facility affiliations

  • Mount Sinai Beth Israel Hospital, New York, NY, CCN 330169
  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • St John'S Riverside Hospital Hospital, Yonkers, NY, CCN 330208

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy24
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248057NYMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Aug 1, 2015 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

10 Union Sq E
Ste 2L
New York, NY 10003
Phone (212) 844-6268

155 White Plains Rd
Ste 109
Tarrytown, NY 10591
Phone (914) 366-6139

Interoperability endpoints

  • Direct secure messaging: jordan.jacobs@direct.hvhc.org

Organizations & group practices 5

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 10

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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1881852564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WHITE PLAINS RD",
            "address_2": "SUITE 109",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WHITE PLAINS RD",
            "address_2": "SUITE 109",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915523",
            "telephone_number": "914-366-6139",
            "fax_number": "866-780-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JORDAN",
        "middle_name": "M.S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "248057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03466075",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarrytown, NY

Sources for this page

Verify at the official NPI Registry.