Active NPI
Harold Jacob, M.D.
- Gastroenterology Physician
- Cedarhurst, NY
National Provider Identifier
1942430269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 136545
- Practice address
- 601 Chestnut St
Apt A19
Cedarhurst, NY 11516-2228 - Phone
- (516) 569-6872
- Fax
- (516) 569-6872
- NPI assigned
- Jul 21, 2009
- Last updated
- Jul 21, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 136545 | NY | Primary |
Addresses
Primary practice location
601 Chestnut St
Apt A19
Cedarhurst, NY 11516-2228
Mailing address
601 Chestnut St
Apt A19
Cedarhurst, NY 11516-2228
Phone (516) 569-6872
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136545 | NY | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248134400000",
"number": "1942430269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 CHESTNUT ST",
"address_2": "APT A19",
"city": "CEDARHURST",
"state": "NY",
"postal_code": "115162228",
"telephone_number": "516-569-6872",
"fax_number": "516-569-6872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CHESTNUT ST",
"address_2": "APT A19",
"city": "CEDARHURST",
"state": "NY",
"postal_code": "115162228",
"telephone_number": "516-569-6872",
"fax_number": "516-569-6872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "HAROLD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-21",
"last_updated": "2009-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "136545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedarhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.