Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jack Xie, MD

Individual provider Internal Medicine Physician · NPI 1720724412

Dr. Jack Xie, MD is an Internal Medicine Physician in Staten Island, New York. Licensed in Illinois. Registered with an NPI since 2022.

Licensed in
IL
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

475 Seaview Ave
Staten Island, NY 10305-3436
Phone: (773) 878-8200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 125.081855 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1720724412
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 6, 2022
Last updated in NPPESJune 17, 2026
Certification dateJune 17, 2026

Other providers in Staten Island