JACK ACKERMAN (NPI# 1780794107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780794107 |
| Entity Type | Individual |
| Full Name | JACK ACKERMAN |
| Credential | DO |
| Practice Address |
227 N Jackson Ave San Jose CA 95116-1603 |
| Mailing Address |
400 Race St San Jose CA 95126-3518 |
| Practice Telephone | 4083472002 |
| Practice Fax Number | 4083472189 |
| Mailing Telephone | 4082783121 |
| Mailing Fax Number | 4082783194 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-03-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 20A6210 | CA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 20A6210 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00AX62100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922084276 | Jack T Ackerman | Dentist | 19059 Valley Blvd, Suite 103, Bloomington, CA 92316-2219 | 2005-12-19 |
| Street Address |
227 N JACKSON AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95116-1603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063461747 | Rasik Kansara | Internal Medicine | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2006-05-09 |
| 1871996520 | Misty Mallari | Registered Nurse | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2014-10-08 |
| 1427450592 | Caroline Ladines | Pharmacist | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2014-09-20 |
| 1639511488 | Maria S Govorkova | Ophthalmology | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2013-07-22 |
| 1013224633 | Verity Medical Foundation | Family Medicine | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2010-09-02 |
| 1073708541 | Vincent Liu | Internal Medicine | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2007-09-07 |
| 1750596755 | Timothy Earl Wiley | Technician/Technologist | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2007-05-11 |
| 1073648739 | Physicians Medical Group of San Jose, Inc. | Non-Pharmacy Dispensing Site | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2007-02-22 |
| 1487708855 | Unilab Corporation | Clinical Medical Laboratory | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2007-01-23 |
| 1326132515 | Mary J. Richardson | Registered Nurse | 227 N Jackson Ave, San Jose, CA 95116-1603 | 2006-10-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821570102 | Lori Chung Cho Dmd Inc. | Clinic/Center | 150 N Jackson Ave Ste 103, San Jose, CA 95116 | 2018-09-03 |
| 1306333174 | Patrick Suezaki | Dentist | 250 Montclair Ave Ste C, San Jose, CA 95116 | 2018-04-17 |
| 1871016147 | Israel Enrique Ruiz Lora | Social Worker | 1075 East Santa Clara, San Jose, CA 95116 | 2017-07-19 |
| 1275072613 | Araceli Yazmin Garcia | Case Manager/Care Coordinator | 1652 E San Fernando St, San Jose, CA 95116 | 2017-02-17 |
| 1710304712 | Natalie K. Huynh D.d.s Inc. | Dentist | 2340 Mckee Rd #24, San Jose, CA 95116 | 2014-03-27 |
| 1437597747 | Ian Ellis Mccoy | Internal Medicine | 2360 Mckee Rd Ste 10, San Jose, CA 95116 | 2013-06-08 |
| 1588913321 | Adrian Fernandez | Counselor | 1245 East Santa Clara Street, San Jose, CA 95116 | 2012-09-07 |
| 1851678841 | Krystal Lani Subia | Counselor | 101 Jose Figueres Avenue, San Jose, CA 95116 | 2011-11-04 |
| 1255668224 | Sophia O.j.m. Dijkstra | Physical Therapist | 180 N. Jackson Ave, San Jose, CA 95116 | 2009-11-11 |
| 1255562096 | Jovan De Guzman Sedilla | Physical Therapy Assistant | 180 N. Jackson Ave., San Jose, CA 95116 | 2009-07-28 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457850455 | Manjari Aravamuthan,m.d.;p.c. | Internal Medicine | 1569 Lexann Ave Ste 220, San Jose, CA 95121-1795 | 2018-02-05 |
| 1841737236 | Maria Cecilia Monge Bonilla | Internal Medicine | 200 Metros Este Del Ampm, Guachipelin Escazu, San Jose, SAN JOSE 1000 | 2017-01-24 |
| 1417305624 | Pydi Akella | Internal Medicine | 1675 Lorient Ter, San Jose, CA 95133-1515 | 2016-05-27 |
| 1508240102 | Srijana Davuluri | Internal Medicine | 751 S Bascom Avenue, San Jose, CA 95128 | 2015-07-13 |
| 1679992986 | Piyanka Estelle Chandra | Internal Medicine | 275 Hospital Pkwy Ste 706, San Jose, CA 95119-1102 | 2014-04-15 |
| 1942622717 | Affordable Unique Health Care Inc | Internal Medicine | 2070 Silence Dr, San Jose, CA 95148-1918 | 2014-01-14 |
| 1700227873 | Yu-chien Cheng | Internal Medicine | 275 Hospital Pkwy Ste 600, San Jose, CA 95119 | 2013-07-17 |
| 1639499866 | Nayyar Mumtaz Masood | Internal Medicine | 4003 Claitor Way, San Jose, CA 95132-3212 | 2010-06-10 |
| 1740507367 | Sweetheart T Ador-dionisio | Internal Medicine | 280 Hospital Pkwy Bldg D, San Jose, CA 95119-1103 | 2010-04-21 |
| 1467775866 | Dinh Xuan Dam M.d. Corporation | Internal Medicine | 200 N Jackson Ave Ste C, San Jose, CA 95116-1601 | 2010-03-12 |
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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.