Individual provider Active NPI

Dayna Jacobson, P.A.-C

  • Physician Assistant
  • Springfield, MA
National Provider Identifier
1386783389
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1411 Issued in MA
Practice address
819 Worcester Street
Suite 3
Springfield, MA 01151
Phone
(413) 543-6820
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1411 MA Primary

Addresses

Primary practice location

819 Worcester Street
Suite 3
Springfield, MA 01151

Mailing address

819 Worcester Street
Suite 3
Springfield, MA 01151
Phone (413) 543-6820

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141013002414 MA Practitioner - Physician Assistant 8022086891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1411MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Massachusetts, Inc Physician Assistant CurrentSince Sep 1, 2016 Accepting new patients
Steward Medical Group, Inc CurrentSince Feb 19, 2023 Accepting new patients
Inpatient Consultants of Massachusetts, P.C. Physician Assistant Past Accepting new patients
Inpatient Consultants of Massachusetts, P.C. Physician Assistant Past Accepting new patients

Locations

200 Groton Rd
Ayer, MA 01432
Phone (978) 784-9000

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

114 Whitwell St
Quincy, MA 02169
Phone (617) 376-4018

5410 Maryland Way
Ste 100
Brentwood, TN 37027
Phone (615) 371-4431

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1386783389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WORCESTER STREET",
            "address_2": "SUITE 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01151",
            "telephone_number": "413-543-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 WORCESTER STREET",
            "address_2": "SUITE 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01151",
            "telephone_number": "413-543-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DAYNA",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.