DR. AMANDA MCNEAR JACOBS (NPI# 1003016411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003016411 |
| Entity Type | Individual |
| Full Name | DR. AMANDA MCNEAR JACOBS |
| Credential | M.D. |
| Practice Address |
111 E 210th St Department of Pediatrics Bronx NY 10467-2401 |
| Mailing Address |
111 E. 211 St Bronx NY 10467 |
| Practice Telephone | 7189202306 |
| Mailing Telephone | 7189202306 |
| Mailing Fax Number | 7189205289 |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2011-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
218283 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003261561 | Amanda Jacobs | Licensed Practical Nurse | 1161 Cain Rd, Youngstown, NY 14174-9768 | 2016-05-03 |
| 1760946289 | Amanda Jacobs | Social Worker | 1859 S Topaz Way Ste 100, Meridian, ID 83642-4401 | 2019-01-29 |
| 1407238090 | Amanda Jacobs | Dentist | 411 Willis St, Taylorsville, MS 39168-4550 | 2015-06-19 |
| 1558619940 | Amanda Kristen Jacobs | Pharmacist | 2707 Celanese Rd, Rock Hill, SC 29732-9406 | 2012-08-16 |
| 1952669467 | Amanda Ann Jacobs | Registered Nurse | 1101 W Liberty St, Farmington, MO 63640-1921 | 2012-05-03 |
| 1164713418 | Amanda Lea Jacobs | Massage Therapist | 3209 E 57th Ave, Spokane, WA 99223-7040 | 2011-04-20 |
| 1740599646 | Amanda J Jacobs | Physician Assistant | 980 S Saint Augustine St, Pulaski, WI 54162-9453 | 2010-09-27 |
| 1427231356 | Amanda Howard Jacobs | Optometrist | 1201 11th Ave S, Suite 501, Birmingham, AL 35205-3410 | 2007-12-13 |
| Street Address |
111 E 210TH ST DEPARTMENT OF PEDIATRICS |
| City | BRONX |
| State | NY |
| Zip Code | 10467-2401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083619373 | Caletha Dicks | Nurse Anesthetist, Certified Registered | 111 E 210th St, Bronx, NY 10467-2401 | 2005-06-14 |
| 1124629118 | Ali Liakat | Pharmacist | 111 E 210th St, Bronx, NY 10467-2401 | 2020-11-05 |
| 1225639347 | Michael Boadu | Pharmacist | 111 E 210th St, Bronx, NY 10467-2401 | 2020-11-04 |
| 1770183501 | Michelle Marsalisi | Physician Assistant | 111 E 210th St, Bronx, NY 10467-2401 | 2020-10-30 |
| 1598364606 | Denise Sarah Dailey | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Bronx, NY 10467-2401 | 2020-10-20 |
| 1619574167 | Amina Khan | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Bronx, NY 10467-2401 | 2020-10-07 |
| 1043817679 | Farzaneh Hosein Khezri | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Bronx, NY 10467-2401 | 2020-10-06 |
| 1366049330 | Shafaq Zaman Tarar | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Bronx, NY 10467-2401 | 2020-10-02 |
| 1972110450 | Assi Milwidsky | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Bronx, NY 10467-2401 | 2020-09-28 |
| 1518574243 | Sudhakar Basetty | Student in an Organized Health Care Education/Training Program | 111 E 210th St, Bronx, NY 10467-2401 | 2020-09-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535505 | Maxwell Ennist | Massage Therapist | 210 Bedford Park Blvd, Bronx, NY 10467 | 2020-10-09 |
| 1144854431 | Ny Metro Dental, PC | Dentist | 55 Mosholu Parkway North, Bronx, NY 10467 | 2020-02-26 |
| 1386277960 | Rhonda Ellen Nayberg | Occupational Therapist | Montefiore Medical Center Occupational Therapy Dept, 111 E 210 Street Ground Floor Blue Zone, Bronx, NY 10467 | 2020-02-21 |
| 1013568153 | Jaime Luis Betancourt | Nurse Practitioner | Sickle Cell Clinic, 3400 Bainbridge Avenue, Bronx, NY 10467 | 2019-09-20 |
| 1023662616 | Bronx Jewish Community Council Home Attendant Services | Home Health | 2930 Wallace Ave., Bronx, NY 10467 | 2019-07-31 |
| 1831755321 | Felix Medrano | Taxi | 3106 Webster Ave, Bronx, NY 10467 | 2019-05-10 |
| 1700363108 | Danaies Guzman | Occupational Therapist | 2410 Barker Avenue Apt 11a, Bronx, New York, NY 10467 | 2018-07-27 |
| 1538672175 | Carolina Duque-toro | Speech-Language Pathologist | 4251, 341 E 207th St, Bronx, NY 10467 | 2017-11-06 |
| 1255853727 | Jessica Perkiss | Social Worker | 750 Tilden St., Astor Services for Children and Families, Bronx, NY 10467 | 2017-07-17 |
| 1386166221 | Erica Santos | Licensed Practical Nurse | 3273 Parkside Place, Apt 5g, Bronx, NY 10467 | 2017-07-12 |
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| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891929311 | Divino Nino Pediatrics | Pediatrics | 557 E Fordham Rd, Bronx, NY 10458-5001 | 2009-05-12 |
| 1558524751 | Jennifer I Davis | Pediatrics | 240 E 172nd St, B-100, Bronx, NY 10457-8903 | 2008-07-08 |
| 1104983592 | Cynthia Lewis | Pediatrics | 2737 Third Avenue, Bronx Care, Bronx, NY 10451 | 2007-01-03 |
| 1932282779 | Arthur Hall | Pediatrics | 3018 Colden Ave, Bronx, NY 10469-3946 | 2006-10-23 |
| 1457441487 | Juan Jose Pilarte | Pediatrics | 1001 Grand Concourse Apt 1e, Bronx, NY 10452-9122 | 2006-10-13 |
| 1538256060 | Luis Alberto Rivera | Pediatrics | 1162 Elder Ave, Bronx, NY 10472-3501 | 2006-10-06 |
| 1679660286 | Jose Tomas Aponte Rodriguez | Pediatrics | 1870 Grand Concourse Fl 3, Bronx, NY 10457-5402 | 2006-10-06 |
| 1588670194 | Tatyana Kizelshteyn | Pediatrics | 2134 Barnes Ave, Bronx, NY 10462-1902 | 2006-08-01 |
| 1225044878 | Gerson Gluck | Pediatrics | 1118 Esplanade Ave, Bronx, NY 10461-1210 | 2006-08-01 |
| 1114968708 | Peter A Masella | Pediatrics | 603 E 187th St, Bronx, NY 10458-6700 | 2006-06-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.