Active NPI
Jan Stephen Close, M.D.
- Internal Medicine Physician
- Potsdam, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 151077
- Practice address
- 50 Leroy St
Potsdam, NY 13676-1786 - Phone
- (315) 265-3300
- NPI assigned
- Nov 14, 2006
- Last updated
- Jul 10, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 151077 | NY | Primary |
Addresses
Primary practice location
50 Leroy St
Potsdam, NY 13676-1786
Mailing address
50 Leroy St
Potsdam, NY 13676-1786
Phone (315) 265-3300
Other practice location 1
133 Park St
Malone, NY 12953-1220
Phone (518) 481-2543
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jclose338010@direct.rochesterregional.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 151077 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Canton-Potsdam Hospital | Current | Accepting new patients | |
| Canton-Potsdam Hospital | Current | Accepting new patients | |
| North Star Emergency Physicians, PC | Past | Accepting new patients |
Locations
1 Hospital Dr
Massena, NY 13662
Phone (315) 764-1711
201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102
50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034
Interoperability endpoints
- jclose338010@direct.rochesterregional.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Potsdam, NY
- NPI 1568548782
-
- Medicare Defined Swing Bed Hospital Unit
- Potsdam, NY
- NPI 1114104445
-
- Emergency Medicine Physician
- Potsdam, NY
- NPI 1063471779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1891867180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 LEROY ST",
"city": "POTSDAM",
"state": "NY",
"postal_code": "136761786",
"telephone_number": "315-265-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 LEROY ST",
"city": "POTSDAM",
"state": "NY",
"postal_code": "136761786",
"telephone_number": "315-265-3300"
}
],
"practiceLocations": [
{
"address_1": "133 Park St",
"address_purpose": "LOCATION",
"city": "Malone",
"state": "NY",
"postal_code": "129531220",
"country_code": "US",
"telephone_number": "518-481-2543",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CLOSE",
"first_name": "JAN",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2024-07-10",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "151077",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jclose338010@direct.rochesterregional.org",
"affiliation": "N",
"address_1": "50 LeRoy St",
"city": "Potsdam",
"state": "NY",
"country_code": "US",
"postal_code": "136761786",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Potsdam, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.