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

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: October 18, 2026.

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

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Jake Kleinmahon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore - Lij Medical PC
0.6 mi
Internal Medicine
270-05 76TH AVE
New Hyde Park, NY 11040
  • Reassigned Medicare billing, New York enrollment
  • 9,353 clinicians in this Medicare group
NPI 1790043479 (516) 465-8089

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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
1111 MARCUS AVE STE M15
NEW HYDE PARK, NY 11042
Nassau County (516) 601-7100
IRA PARNESS MD
Pediatrics (Pediatric Cardiology)
1111 MARCUS AVE STE M15
NEW HYDE PARK, NY 11042
Nassau County (516) 601-7200
DR. KONSTANTIN AVERIN M.D.
Pediatrics (Pediatric Cardiology)
1111 MARCUS AVE STE M15
NEW HYDE PARK, NY 11042
Nassau County (516) 601-7303
MR. ISAAC HAMMOND JR. PA-C
Physician Assistant
1111 MARCUS AVE STE M15
NEW HYDE PARK, NY 11042
Nassau County (516) 601-7304
RACHEL BLUMBERG RD, CDN
Dietitian, Registered
1111 MARCUS AVE STE M15
NEW HYDE PARK, NY 11042
Nassau County (516) 601-7200
DR. HARI GANESH RAJAGOPAL MBBS
Pediatrics (Pediatric Cardiology)
1111 MARCUS AVE STE M15
NEW HYDE PARK, NY 11042
Nassau County (516) 601-7200
DR. ELISA RHEE M.B.B.CH.
Pediatrics (Pediatric Cardiology)
1111 MARCUS AVE STE M15
NEW HYDE PARK, NY 11042
Nassau County (516) 601-7303
MS. NANCY PATRICIA MCKENNA CPNP-PC
Pediatrics
1111 MARCUS AVE STE M15
NEW HYDE PARK, NY 11042
Nassau County (516) 601-7200

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 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.

Where is Jake Kleinmahon located?

Jake Kleinmahon practices at 1111 Marcus Ave Ste M15, New Hyde Park, NY 11042. The listed phone number is (516) 601-7200.

What is Jake Kleinmahon's specialty?

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

Is Jake Kleinmahon enrolled in Medicare?

Yes. Jake Kleinmahon is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jake Kleinmahon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jake Kleinmahon reassigns Medicare benefits to North Shore - Lij Medical PC (New Hyde Park, NY). The 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 Jake Kleinmahon'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 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 20 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.