Jacob J Venter, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

210085 Issued in MA

Practice address

Cha - Psychiatry - Adolescent Assessment Unit
1493 Cambridge Street
Cambridge, MA 02139

Phone

(617) 575-5460

NPI assigned

Oct 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jventer184116@direct.bilh.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Behavioral Health Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beverly, MA
  • NPI 1154302586
  NPD
• Phoenix Children'S Hospital

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1922112044
  NPD
• Phoenix Children'S Medical Group

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1487814240
  NPD
• Psychiatric Associates of Malden, P.C.

  • Psychiatry Physician
  • Malden, MA
  • NPI 1699815910
  NPD (past)
• Phoenix Children'S Hospital Hope

  • Pharmacy
  • Phoenix, AZ
  • NPI 1386749836
  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1063402378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHA - PSYCHIATRY - ADOLESCENT ASSESSMENT UNIT",
            "address_2": "1493 CAMBRIDGE STREET",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02139",
            "telephone_number": "617-575-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHA - PSYCHIATRY - ADOLESCENT ASSESSMENT UNIT",
            "address_2": "1493 CAMBRIDGE STREET",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "02139",
            "telephone_number": "617-575-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTER",
        "first_name": "JACOB",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AZ",
            "license": "32812",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "210085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J25693",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "S400413978",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110034921A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "459239",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Velie
• Bettina Velona
• Linda Gorman Vena
• Shyamala Venkataraman, PH.D.
• Uma Indu Venkatraman
• Katherine Venturo-Conerly, MA
• Vijay Venugopal, M.D
• Soledad C Vera, PHD
• Catarine Verdi
• Soimise Verdieu, APRN

• Psychiatry Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.