Individual provider Active NPI

Carline Louis-Jacques, M.D., M.P.H.

  • Obstetrics & Gynecology Physician
  • Newburgh, NY
National Provider Identifier
1942375928
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
186848 Issued in NY
Practice address
147 Lake St
Newburgh, NY 12550-5263
Phone
(845) 563-8000
NPI assigned
Nov 22, 2006
Last updated
Mar 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G86204 CA
Obstetrics & Gynecology Physician 207V00000X 186848 NY Primary

Addresses

Primary practice location

147 Lake St
Newburgh, NY 12550-5263

Mailing address

2570 Route 9W Ste 10
Cornwall, NY 12518-1370
Phone (845) 220-3100

Other identifiers 2

IdentifierTypeStateIssuer
01427536MedicaidNY
00G862040MedicaidCA

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
I20210325000332 NY Practitioner - Obstetrics/Gynecology 9739111618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Albert Einstein College of Medicine of Yeshiva University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Family HealthcareGroup PAC ID 4880610393, 67 clinicians

Practice addresses (Care Compare)

147 Lake St
Newburgh, NY 12550-5263
Phone (845) 563-8000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G86204CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Family Healthcare CurrentSince Apr 2, 2022 Accepting new patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Apr 19, 2021 Accepting new patients
Cornerstone Family Healthcare CurrentSince Apr 2, 2022 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

2412 Church Ave
Brooklyn, NY 11226
Phone (347) 404-5950

2570 US Highway 9W
Ste 10
Cornwall, NY 12518
Phone (845) 220-3100

127 Main St
Highland Fls, NY 10928
Phone (845) 446-4040

10 Benton Ave
Middletown, NY 10940
Phone (845) 343-0881

14 Grove St
Middletown, NY 10940
Phone (845) 342-6601

147 Lake St
Newburgh, NY 12550

99 Cameron St
Pine Bush, NY 12566
Phone (845) 744-2067

140 Hammond St
Port Jervis, NY 12771
Phone (845) 858-2854

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGCECD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1942375928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 ROUTE 9W STE 10",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181370",
            "telephone_number": "845-220-3100",
            "fax_number": "845-534-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 LAKE ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125505263",
            "telephone_number": "845-563-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS-JACQUES",
        "first_name": "CARLINE",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G86204",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "186848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01427536",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G862040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.