DR. JESSE MARTIN VICTORY (NPI# 1427492743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427492743 |
| Entity Type | Individual |
| Full Name | DR. JESSE MARTIN VICTORY |
| Credential | D.O. |
| Practice Address |
111 E 210th St Bronx NY 10467 |
| Mailing Address |
515 83rd St Fl 1 Brooklyn NY 11209-4503 |
| Practice Telephone | 7189204321 |
| Mailing Telephone | 9175882907 |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2019-02-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 293987 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 150 55th St, Brooklyn, NY 112202508 | 7186307000 |
| Street Address |
111 E 210TH ST |
| City | BRONX |
| State | NY |
| Zip Code | 10467 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073889085 | Shruti Sharma | Surgery | 6255 Broadway Apt 5b, Bronx, NY 10471 | 2012-03-25 |
| 1518292531 | Dag Medical, PC | Surgery | 3411 White Plains Rd, Bronx, NY 10467-5704 | 2009-10-08 |
| 1093945875 | Srinivas H Reddy | Surgery | 1400 Pelham Pkwy S., Bldg #1, Suite 1213 Jacobi Medical Center, Bronx, NY 10461 | 2009-07-15 |
| 1043452964 | Jeannine K Giacovelli | Surgery | 158r Hawkins St., Bronx, NY 10464 | 2009-03-25 |
| 1487810289 | Robert L Plummer Md Facs PC | Surgery | 176 E Mosholu Pk Wy S, Bronx, NY 10458-1174 | 2008-07-31 |
| 1356530539 | Sergio L. Baerga | Surgery | 3400 Bainbridge Ave. 4th Floor, Montefiore Medical Center - Department of Surgery, Bronx, NY 10467-2401 | 2007-10-23 |
| 1265557185 | Edward Hatfield Lowe Jr. | Surgery | 30 Pilot St, Bronx, NY 10464-1630 | 2007-03-20 |
| 1073645495 | Walter J.b. Hodgson | Surgery | 1575 Blondell Avenue, Ste. 125, Montefiore Medical Park, Bronx, NY 10461 | 2007-03-12 |
| 1154409852 | Matthew L Genovese | Surgery | 3257 Waterbury Ave, Bronx, NY 10465-1464 | 2006-11-01 |
| 1669557625 | Harold Brem | Surgery | 2500 Johnson Ave, Apt. 3d, Bronx, NY 10463-4925 | 2006-10-26 |
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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.