Carolyn Rosa Jacobson, RN, MSN, CPNP

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

RN2302522 Issued in MA

Practice address

300 Longwood Ave
Boston, MA 02115-5724

Phone

(617) 355-6439

NPI assigned

Oct 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjacobson27720@direct.bostonchildrens.org

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.

• Children'S Hospital Pediatric Associates, Inc

  • Pediatrics Physician
  • Boston, MA
  • NPI 1457306664
  Medicare reassignment NPD

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1528310257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000",
            "fax_number": "617-730-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1830 Town Center Drive, Suite # 205",
            "address_2": "Reston Town Center Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Reston",
            "state": "VA",
            "postal_code": "20190",
            "country_code": "US",
            "telephone_number": "703-435-0325",
            "fax_number": "703-435-9145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "CAROLYN",
        "middle_name": "ROSA",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024170287",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN2302522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine Karen Jacobsohn, RN-PCNS
• Alan Marc Jacobson, M.D.
• Alex Jacobson, MD
• Benjamin Howard Jacobson, MD
• Brian C. Jacobson, MD, MPH
• Caron Alyce Jacobson, MD
• Daniel R Jacobson, M.D.
• Joseph O Jacobson, MD
• Karen Rita Jacobson, MD
• Lee S. Jacobson, M.D., PH.D.

• Pediatric Registered Nurse in Boston, MA
• Providers in Boston, MA by specialty
• Pediatric Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.