NPIMap

Organization Active NPI

Nassau Pulmonary & Critical Care Medicine PC

  • Specialist
  • Great Neck, NY
National Provider Identifier
1942415286
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NASSAU PULMONARY & CRITICAL CARE MEDICINE PC
Practice address
891 Northern Blvd
Suite 203
Great Neck, NY 11021-5334
Phone
(516) 773-6300
Fax
(516) 706-4700
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Authorized official

Name
Dr. Mitchel C Jacobs, MDNPI 1144380205
Title
Owner
Phone
(516) 773-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

891 Northern Blvd
Suite 203
Great Neck, NY 11021-5334

Mailing address

891 Northern Blvd
Suite 203
Great Neck, NY 11021-5305
Phone (516) 773-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070514000421 NY Part B Supplier - Clinic/Group Practice 1355448127 Receives reassigned benefits from 8 practitioners
Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1942415286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 NORTHERN BLVD",
            "address_2": "SUITE 203",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215305",
            "telephone_number": "516-773-6300",
            "fax_number": "516-706-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 NORTHERN BLVD",
            "address_2": "SUITE 203",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215334",
            "telephone_number": "516-773-6300",
            "fax_number": "516-706-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASSAU PULMONARY & CRITICAL CARE MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "MITCHEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-773-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.