NPIMap

Individual provider Active NPI

Jakob Michael Tu Moran, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Boston, MA
National Provider Identifier
1083174197
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
76776 Issued in CT
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 726-2000
NPI assigned
Mar 24, 2019
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 76776 CT Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

324 East 41St Street
Apt. 702C
New York City, NY 10017
Phone (917) 679-4922

Other practice location 1

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 647-6487

Other practice location 2

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240403001976 CT Practitioner - Pathology 1951630144
I20240815001923 MA Practitioner - Pathology 1951630144 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

243 Charles St
Suite 1107
Boston, MA 02114-3002
Phone (617) 273-5699

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
55.67 of 100Reported as group
Quality
46.42
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76776CTMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince May 25, 2025 Accepting new patients
Brigham & Womens Physicians Organization Inc Anatomic Pathology & Clinical Pathology CurrentSince May 25, 2025 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Anatomic Pathology & Clinical Pathology CurrentSince May 25, 2025 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

75 Francis St
Boston, MA 02115

Interoperability endpoints

  • Direct secure messaging: moran.jakob.mgh@direct.partners.masshiway.net

Organizations & group practices 5

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

Hospital & facility affiliations 5

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1083174197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 EAST 41ST STREET",
            "address_2": "APT. 702C",
            "city": "NEW YORK CITY",
            "state": "NY",
            "postal_code": "10017",
            "telephone_number": "917-679-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Haynes St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "CT",
            "postal_code": "060404131",
            "country_code": "US",
            "telephone_number": "860-647-6487",
            "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": "617-732-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JAKOB",
        "middle_name": "MICHAEL TU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CT",
            "license": "76776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.