Active NPI
Jacob Matthew Patkin
- Counselor
- Watertown, MA
National Provider Identifier
1104528942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 521 Mount Auburn St Ste 205
Watertown, MA 02472-4153 - Phone
- (617) 855-9295
- NPI assigned
- Mar 17, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
521 Mount Auburn St Ste 205
Watertown, MA 02472-4153
Mailing address
41 Ossipee Rd Apt 1
Somerville, MA 02144-1609
Phone (617) 855-9295
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758844800000",
"number": "1104528942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 OSSIPEE RD APT 1",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021441609",
"telephone_number": "617-855-9295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "521 MOUNT AUBURN ST STE 205",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724153",
"telephone_number": "617-855-9295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATKIN",
"first_name": "JACOB",
"middle_name": "MATTHEW",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-17",
"last_updated": "2025-09-26",
"certification_date": "2025-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.