Individual provider Active NPI

Selvin Sam Jacob, MD

  • Pulmonary Disease Physician
  • Boston, MA
National Provider Identifier
1073040333
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
1016275 Issued in MA
Practice address
15 Parkman St
Boston, MA 02114-2696
Phone
(617) 726-1721
NPI assigned
May 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD19461 RI
Pulmonary Disease Physician 207RP1001X 1016275 MA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD19461 RI
Internal Medicine Physician 207R00000X MT213402 PA

Addresses

Primary practice location

15 Parkman St
Boston, MA 02114-2696

Mailing address

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5000

Other practice location 1

55 Fruit Street
Boston, MA 02114-2696
Phone (617) 726-1721

Other practice location 2

230 N Broad St
Philadelphia, PA 19102-1121
Phone (215) 762-2632

Other practice location 3

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5000

Other practice location 4

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Other practice location 5

1153 Centre St
Jamaica Plain, MA 02130-3446
Phone (617) 983-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230828001701 MA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 5890032668 Reassigns benefits to 5 organizations
I20231006002570 RI Practitioner - Internal Medicine 5890032668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1016275MAMDClinical Social Worker
MT213402PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Sep 15, 2023 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
South Shore Medical Center, Inc. Internal Medicine CurrentSince Feb 26, 2026 Accepting new patients
Coastal Medical Associates CurrentSince Feb 26, 2026 Accepting new patients
Affinity Physicians LLC. Internal Medicine CurrentSince Sep 15, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Sep 1, 2025 Accepting new patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Sep 15, 2023 Accepting new patients
Brigham & Womens Hospital, Inc. Past Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

15 Parkman St
Boston, MA 02114
Phone (617) 726-3023

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

75 Francis St
Boston, MA 02115

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

5 Tarkiln Rd
Kingston, MA 02364
Phone (781) 585-2200

254 2nd Ave
Needham Heights, MA 02494
Phone (781) 416-8414

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: jacob.selvin.bwh@direct.partners.masshiway.net
  • Direct secure messaging: sjacob41400@direct.uth.org
  • Direct secure messaging: ssjacob@direct.carene.org

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1073040333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit Street",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142696",
            "country_code": "US",
            "telephone_number": "617-726-1721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "230 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021121",
            "country_code": "US",
            "telephone_number": "215-762-2632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1153 Centre St",
            "address_purpose": "LOCATION",
            "city": "Jamaica Plain",
            "state": "MA",
            "postal_code": "021303446",
            "country_code": "US",
            "telephone_number": "617-983-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SELVIN",
        "middle_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "RI",
            "license": "MD19461",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "1016275",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "RI",
            "license": "MD19461",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT213402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.