Jacob Michael Kayle Lister, MD, PHD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

78962 Issued in CT

Practice address

230 S Frontage Rd
New Haven, CT 06519-1124

Phone

(203) 737-7129

NPI assigned

Apr 14, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Interoperability endpoints

• Direct secure messaging: jlister570494@direct.ynhh.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1063155588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S FRONTAGE RD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191124",
            "telephone_number": "203-737-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 S FRONTAGE RD",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191124",
            "telephone_number": "203-737-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTER",
        "first_name": "JACOB",
        "middle_name": "MICHAEL KAYLE",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-14",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "78962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristina Liriano Cepin
• Sean Ervin Lisk, PA-C
• Ellen Beth Liskov, RD, MPH, CDE
• Sean Aaron Lisse, M.D.
• George Lister Jr., MD
• Alexander Brave Listur, MD
• Tori Litchfield
• Alicia Joan Little, M.D.
• Parris Little
• Cathy Liu, CRNA

• Child & Adolescent Psychiatry Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Child & Adolescent Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.