Organization Active NPI

Jean-Claude Jean MD PC

  • Internal Medicine Physician
  • Jamaica, NY
National Provider Identifier
1922374768
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JEAN-CLAUDE JEAN MD PC
Practice address
11572 Francis Lewis Blvd
Jamaica, NY 11411-1028
Phone
(718) 712-6660
Fax
(718) 712-3478
NPI assigned
Mar 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Authorized official

Name
Dr. Jean-Claude Jean, MD
Title
Owner
Phone
(718) 712-6660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

11572 Francis Lewis Blvd
Jamaica, NY 11411-1028

Mailing address

115 72 Francis Lewis Blvd
Jamaica, NY 11411-1028
Phone (718) 712-6660

Other identifiers 1

IdentifierTypeStateIssuer
00773611MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1922374768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 72 FRANCIS LEWIS BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114111028",
            "telephone_number": "718-712-6660",
            "fax_number": "718-712-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11572 FRANCIS LEWIS BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114111028",
            "telephone_number": "718-712-6660",
            "fax_number": "718-712-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN-CLAUDE JEAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "JEAN",
        "authorized_official_first_name": "JEAN-CLAUDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-712-6660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00773611",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.