RICHARD ANTHONY JACK M.D.
NPI 1306289129
Pediatrics - Neonatal-Perinatal Medicine in Tarzana, CA

Q: What is Richard Jack's NPI number?

The NPI number for Richard Jack is 1306289129. It was assigned to this individual provider in the NPPES registry on April 10, 2013.

Q: What is Richard Jack's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Q: When was this NPI record last updated?

The NPPES record for Richard Jack was last updated on December 28, 2022. 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.

Active since April 10, 2013PECOS Enrolled

18321 CLARK ST, TARZANA, CA 91356(818) 708-5570(818) 708-5471 Get Directions Write a Review

NPPES record last updated: December 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Richard Anthony Jack M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICHARD ANTHONY JACK M.D. (NPI 1306289129) is an individual neonatal-perinatal medicine provider in Tarzana, California, licensed in California (C175889) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS and maintains a secondary practice location in Hershey.

NPPES Registry Identity

NPI1306289129

Entity TypeIndividualMale

Primary Taxonomy2080N0001X

Provider Legal NameRICHARD ANTHONY JACKCredential: M.D.

Location Address18321 CLARK STTarzana, CA 91356-3501

Mailing Address4140 W 190th StTorrance, CA 90504-5513

Phone(818) 708-5570

Fax(818) 708-5471

Sole ProprietorNo

Enumeration DateApril 10, 2013

Last NPPES UpdateDecember 28, 2022

NPPES CertifiedDecember 28, 2022

✔ NPI 1306289129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

License✔ Licensed in CA · C175889

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

18321 CLARK ST, Tarzana, CA 91356

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Secondary Practice Location 1

Location 1500 University Dr, H085Hershey, PA 17033-2360 · Phone (917) 405-2405

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HMSA, Kaiser Permanente.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Richard Anthony Jack M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

DR. JONATHAN ANDREW PRINCE M.D.

Emergency Medicine