Individual provider Active NPI

Archimedes B Jao, M.D.

  • General Practice Physician
  • Brooklyn, NY
National Provider Identifier
1932438470
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
245608 Issued in NY
Practice address
2640 Pitkin Ave
Brooklyn, NY 11208-2629
Phone
(718) 827-8700
NPI assigned
Dec 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 245608 NY Primary

Addresses

Primary practice location

2640 Pitkin Ave
Brooklyn, NY 11208-2629

Mailing address

569 Ashland Ave
North Baldwin, NY 11510-2624
Phone (347) 331-2829

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160601000392 NY Practitioner - Internal MedicinePractitioner - Infectious Disease 0547550782 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Housing Works Health Services III, Inc. CurrentSince May 1, 2016 Accepting new patients
Housing Works Health Services III, Inc. Past Accepting new patients

Locations

57 Willoughby St
Brooklyn, NY 11201
Phone (718) 408-6522

57 Willoughby St
Lowr
Brooklyn, NY 11201
Phone (718) 408-6522

57 Willoughby St
Fl 2
Brooklyn, NY 11201
Phone (347) 473-7475

Networks

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

Interoperability endpoints

  • Direct secure messaging: archimedes.jao.1@31562.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1932438470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 ASHLAND AVE",
            "city": "NORTH BALDWIN",
            "state": "NY",
            "postal_code": "115102624",
            "telephone_number": "347-331-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 PITKIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112082629",
            "telephone_number": "718-827-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAO",
        "first_name": "ARCHIMEDES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-11",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "245608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.