Tiffany Sam Jacobs

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL89607 Issued in MA

Practice address

133 Highland Ave
Salem, MA 01970-2774

Phone

(978) 741-0666

NPI assigned

Jul 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Tiffany Sam Former name

Medicare fee-for-service enrollment

Enrolled in DC, MD, WA, MA4 enrollments

Enrollment records 4

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay State Physical Therapy of Randolph IncGroup PAC ID 6305744251, 451 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bay State Physical Therapy of Randolph Inc

  • Physical Therapist
  • Fall River, MA
  • NPI 1164474334
  Medicare reassignment Care Compare group
• LHMG Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Annapolis, MD
  • NPI 1396122842

  Physical Therapist

  Medicare reassignment NPD
• LHMG Physical Therapy, LLC

  • Physical Therapist
  • Bowie, MD
  • NPI 1750769055

  DC

  Medicare reassignment NPD
• Physiotherapy Associates, Inc.

  • Physical Therapist
  • Kirkland, WA
  • NPI 1497211049
  Medicare reassignment NPD
• Select Physical Therapy Holdings Inc

  • Rehabilitation Clinic/Center
  • Bethesda, MD
  • NPI 1861460917
  Medicare reassignment NPD
• LHMG Physical Therapy, LLC

  • Physical Therapist
  • Annapolis, MD
  • NPI 1134763212
  NPD
• LHMG Physical Therapy, LLC

  • Physical Therapist
  • Chester, MD
  • NPI 1386286987
  NPD
• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD
• Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD
• Select Physical Therapy Holdings, Inc.

  • Physical Therapy Clinic/Center
  • Frederick, MD
  • NPI 1467122853
  NPD

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1194458703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-961-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702774",
            "telephone_number": "978-741-0666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 Pacific Hwy S",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "WA",
            "postal_code": "981989250",
            "country_code": "US",
            "telephone_number": "253-839-9280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "TIFFANY",
        "middle_name": "SAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "CP038715T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "CP049787T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29136",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL89607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "SAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ali Jabari, M.D.
• Katheryn Jablonski
• Jacklyn Powers, LLC
• Chrystin Jackson
• Richard M Jackson, MD
• Christopher Jacques, PHARMD
• Amita Jain, M.D.
• Teasha Jaksland
• Mazda Jalali, MD
• James J Jervinis,D.M.D.,P.C.

• Physical Therapist in Salem, MA
• Providers in Salem, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.