Jacob Koldin

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

3016229 Issued in MA

Practice address

170 Morton St
Jamaica Plain, MA 02130-3735

Phone

(617) 522-8110

NPI assigned

May 1, 2024

Last updated

May 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jkoldin452088@direct.bilh.masshiway.net

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1578310389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 LINWOOD LN",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042111",
            "telephone_number": "315-447-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-522-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLDIN",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "3016229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorothy E Knox, M.ED
• Rebecca L Knudsen
• Elizabeth Kobzik, MSW
• John Kohler, M.A., CADAC, LADC
• Linda H Kohler
• Daniel Michael Koncelik, LMT
• Joseph William Kopp, M.D.
• Leah Koretz, LMHC
• Christina Victoria Korin
• Miriam Korlansky

• Student in an Organized Health Care Education/Training Program in Jamaica Plain, MA
• Providers in Jamaica Plain, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.