Jacob Mourtada

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

340 Maple St
Marlborough, MA 01752-3200

Phone

(508) 485-9300

NPI assigned

Sep 8, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 Health Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1225067481
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1184238198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LAUREL TREE DR",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020351747",
            "telephone_number": "508-641-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "508-485-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURTADA",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Morten
• Miranda Rose Moscatelli
• Brianna Motroni
• Alene Motta
• Hania Vanessa Moubacher
• Jason Moy
• Katherine Elizabeth Moynihan
• Jacqueline Madison Mozley, RBT
• MPGT Corp
• Courtney A Muhammad

• Mental Health Counselor in Marlborough, MA
• Providers in Marlborough, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.