Active NPI
Maud Jacob
- Surgery Physician
- Brooklyn, NY
National Provider Identifier
1891168340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- P99938
- Practice address
- 374 Stockholm St
Brooklyn, NY 11237-4006 - Phone
- (410) 940-1529
- NPI assigned
- Nov 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | P99938 | NY | Primary |
Addresses
Primary practice location
374 Stockholm St
Brooklyn, NY 11237-4006
Mailing address
13020 116TH Ave
Jamaica, NY 11420-2622
Phone (410) 940-1529
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P99938 | NY | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446681600000",
"number": "1891168340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13020 116TH AVE",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114202622",
"telephone_number": "410-940-1529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 STOCKHOLM ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112374006",
"telephone_number": "410-940-1529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "MAUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-05",
"last_updated": "2015-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NY",
"license": "P99938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.