NPIMap

Individual provider Active NPI

Mitchell Scott Jacobson, M.D.

  • Nephrology Physician
  • Peabody, MA
National Provider Identifier
1396774931
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
150166 Issued in MA
Practice address
6 Essex Center Dr
Suite 306
Peabody, MA 01960-2910
Phone
(978) 531-0677
Fax
(978) 531-5676
NPI assigned
Jul 3, 2006
Last updated
Jan 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 150166 MA Primary

Addresses

Primary practice location

6 Essex Center Dr
Suite 306
Peabody, MA 01960-2910

Mailing address

6 Essex Center Dr
Suite 306
Peabody, MA 01960-2910
Phone (978) 531-0677

Other identifiers 1

IdentifierTypeStateIssuer
3178102MedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jacobson.Mitchell.RENIN@direct.partners.masshiway.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325000851 MA Practitioner - NephrologyPractitioner - Internal Medicine 0840357133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of Ny Upstate Medical University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renin Associates PCGroup PAC ID 5597822882, 5 clinicians

Practice addresses (Care Compare)

6 Essex Ctr Dr
Suite 306
Peabody, MA 01960-2907
Phone (978) 531-0677

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
88.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Renin Associates, P.C. Nephrology CurrentSince Jul 15, 1996 Accepting new patients

Locations

6 Essex Center Dr
Ste 306
Peabody, MA 01960
Phone (508) 531-0677

Interoperability endpoints

  • Direct secure messaging: jacobson.mitchell.renin@direct.partners.masshiway.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1396774931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ESSEX CENTER DR",
            "address_2": "SUITE 306",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602910",
            "telephone_number": "978-531-0677",
            "fax_number": "978-531-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ESSEX CENTER DR",
            "address_2": "SUITE 306",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602910",
            "telephone_number": "978-531-0677",
            "fax_number": "978-531-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "MITCHELL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "150166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3178102",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jacobson.Mitchell.RENIN@direct.partners.masshiway.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIE",
            "address_1": "6 Essex Center Dr",
            "address_2": "SUITE 306",
            "city": "Peabody",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019602910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.