Aleyamma Jacob, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN247194 Issued in MA

Practice address

610 North St
Pittsfield, MA 01201-4105

Phone

(413) 447-2684

Fax

(413) 445-9197

NPI assigned

Mar 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Aleyamma Chacko Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Berkshire Faculty Services Inc

  • Multi-Specialty Clinic/Center
  • Pittsfield, MA
  • NPI 1548212939
  Medicare reassignment NPD
• Ipc Hospitalists of New England, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1659555266

  Family

  Medicare reassignment NPD
• Fairview Hospital

  • Rural Health Clinic/Center
  • Great Barrington, MA
  • NPI 1881252286
  NPD
• Ipc Hospitalists of New England PC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1801330287
  NPD
• Ipc Hospitalists of New England, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1932516176

  Family

  NPD

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1497116255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014105",
            "telephone_number": "413-447-2684",
            "fax_number": "413-445-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014105",
            "telephone_number": "413-447-2684",
            "fax_number": "413-445-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ALEYAMMA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN247194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEYAMMA",
            "last_name": "CHACKO",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zaigham Ul Islam
• Anielle Rose Iwanicki, MSW
• Narjes Jaafar-Snee, MD
• Taylor Shauntai Jackson, MSW
• Claire Marcia Jacob-Zysman, MA, R-DMT
• Anaelisa Jacobsen, MSW
• Jacs Ops IV, Inc.
• Mark Jagiello
• Veena Jain
• Jennifer James

• Family Nurse Practitioner in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.