Individual provider Active NPI

Jacob C Holzer, M.D.

  • Psychiatry Physician
  • Westborough, MA
National Provider Identifier
1144235433
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
74258 Issued in MA
Practice address
Westborough State Hospital
288 Lyman St
Westborough, MA 01581
Phone
(508) 616-2525
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 74258 MA Primary

Addresses

Primary practice location

Westborough State Hospital
288 Lyman St
Westborough, MA 01581

Mailing address

Westborough State Hospital
288 Lyman St
Westborough, MA 01581
Phone (508) 616-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040330000985 MA Practitioner - PsychiatryPractitioner - Neuropsychiatry 8224020599 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Tufts University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians

Practice addresses (Care Compare)

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-3450

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74258MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Jun 9, 2011 Accepting new patients
The McLean Hospital Corporation Psychiatry CurrentSince Feb 19, 2013 Accepting new patients
Massachusetts General Physicians Organization Inc Psychiatry CurrentSince Jun 9, 2011 Accepting new patients
North Suffolk Community Services Inc. PastSince Oct 20, 1997 Accepting new patients
University of Massachusetts Past Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

125 Nashua St
Boston, MA 02114
Phone (617) 573-2687

55 Fruit St
Boston, MA 02114

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

Interoperability endpoints

  • Direct secure messaging: holzer.jacob.mgh@direct.partners.masshiway.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144235433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WESTBOROUGH STATE HOSPITAL",
            "address_2": "288 LYMAN ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "01581",
            "telephone_number": "508-616-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WESTBOROUGH STATE HOSPITAL",
            "address_2": "288 LYMAN ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "01581",
            "telephone_number": "508-616-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZER",
        "first_name": "JACOB",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "74258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

Verify at the official NPI Registry.