DR. JAKE ALEXANDER KLEINMAHON MD
NPI 1629368014
Pediatrics - Pediatric Cardiology in New Hyde Park, NY

Q: What is Jake Kleinmahon's NPI number?

The NPI number for Jake Kleinmahon is 1629368014. It was assigned to this individual provider in the NPPES registry on April 19, 2011.

Q: What is Jake Kleinmahon's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Q: When was this NPI record last updated?

The NPPES record for Jake Kleinmahon was last updated on January 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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 19, 2011PECOS Enrolled

1111 MARCUS AVE STE M15, NEW HYDE PARK, NY 11042(516) 601-7200 Get Directions Write a Review

NPPES record last updated: January 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 13, 2018, Aug 31, 2016 (2 updates tracked since 2016).

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About Dr. Jake Alexander Kleinmahon Md NPPES

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

DR. JAKE ALEXANDER KLEINMAHON MD (NPI 1629368014) is an individual pediatric cardiology provider in New Hyde Park, New York, licensed in New York (325391) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629368014

Entity TypeIndividualMale

Primary Taxonomy2080P0202X

Provider Legal NameDR. JAKE ALEXANDER KLEINMAHONCredential: MD

Location Address1111 MARCUS AVE STE M15New Hyde Park, NY 11042-1034

Mailing Address9 Canterbury LnRoslyn Heights, NY 11577-1401 · (914) 420-4678

Phone(516) 601-7200

Sole ProprietorNo

Enumeration DateApril 19, 2011

Last NPPES UpdateJanuary 20, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 20, 2025

✔ NPI 1629368014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0202X

License✔ Licensed in NY · 325391

Definition

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

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

1111 MARCUS AVE STE M15, New Hyde Park, NY 11042

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jake Alexander Kleinmahon Md 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 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. NOREEN ELIZABETH GOMILLION PA

Physician Assistant