Douglas George Jacobs, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

34367 Issued in MA

Practice address

Professional Psychiatric Assoc
33 Lillian Way
Wayland, MA 01778

Phone

(781) 591-5221

Fax

(781) 235-6390

NPI assigned

Jun 15, 2006

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1497799076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PROFESSIONAL PSYCHIATRIC ASSOC",
            "address_2": "33 LILLIAN WAY",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "01778",
            "telephone_number": "781-591-5221",
            "fax_number": "781-235-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PROFESSIONAL PSYCHIATRIC ASSOC",
            "address_2": "33 LILLIAN WAY",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "01778",
            "telephone_number": "781-591-5221",
            "fax_number": "781-235-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "DOUGLAS",
        "middle_name": "GEORGE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "34367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Wayland, MA
• Providers in Wayland, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.