DR. MARK AARON JACKNIN D.O.
NPI 1033179338
Family Medicine in New York, NY
About Dr. Mark Aaron Jacknin D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MARK AARON JACKNIN D.O. (NPI 1033179338) is an individual family medicine provider in New York, New York, licensed in New York (230171) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Passaic, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2002).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Mark Aaron Jacknin D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Mark Jacknin reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Brooklyn, NY 11212
- Reassigned Medicare billing, New York enrollment
- Medicare enrollment name: Griffin Myers Medical PC
- 101 clinicians in this Medicare group
Lakewood, NJ 08701
- Reassigned Medicare billing, New Jersey enrollment
- 149 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10040 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10040
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mark Jacknin's NPI number?
The NPI number for Mark Jacknin is 1033179338. It was assigned to this individual provider in the NPPES registry on March 23, 2006.
Where is Mark Jacknin located?
Mark Jacknin practices at 4405 Broadway, New York, NY 10040. The listed phone number is (212) 740-2020.
What is Mark Jacknin's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Mark Jacknin enrolled in Medicare?
Yes. Mark Jacknin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Mark Jacknin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Jacknin reassigns Medicare benefits to 2 organizations: Oak Street Health Of New York Medical Group PC (Brooklyn, NY) and Lakewood Resource And Referral Center Inc (Lakewood, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Jacknin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mark Jacknin was last updated on September 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Mark Aaron Jacknin, D.O. · NPI 1033179338
Family Medicine physician in New York, New York. Individual provider, active in the CMS NPPES registry since March 23, 2006.
## Identity
- **NPI:** 1033179338 (Entity type: Individual)
- **Enumerated:** March 23, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 230171 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4405 BROADWAY, New York, NY 10040-4014
- **Phone:** (212) 740-2020 · **Fax:** (646) 666-0280
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Oak Street Health Of New York Medical Group PC (NPI 1780209445, Brooklyn, NY); Lakewood Resource And Referral Center Inc (NPI 1083748297, Lakewood, NJ) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** New York College Of Osteo Medicine Of New York Institute Of Technology, class of 2002
## Record status
- **NPPES last updated:** September 1, 2023
- **Other identifiers:** Medicaid 02716663 (NY)
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Source: [NPI Profile](https://npiprofile.com/npi/1033179338) · Data from the CMS NPPES public registry.