Kimberly Jacobs, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9203 Issued in MA

Practice address

41 Mall Rd
Burlington, MA 01805-4210

Phone

(781) 744-8000

NPI assigned

Jun 15, 2016

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

Other names 1

• Kimberly Mayers Former name

Medicare fee-for-service enrollment

Enrolled in SC, MA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjacobs196883@direct.bilh.masshiway.net

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.

• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• Lahey Clinic, Inc.

  • Internal Medicine Physician
  • Burlington, MA
  • NPI 1538194980
  Medicare reassignment NPD
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment NPD
• Greenville Health System

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1568532513
  Medicare reassignment
• Piedmont Family Practice LLC

  • General Practice Physician
  • Piedmont, SC
  • NPI 1437208790
  Medicare reassignment
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1649726738
  Medicare reassignment
• Baptist Easley

  • Hospitalist Physician
  • Easley, SC
  • NPI 1154859031

  Physician Assistant

  NPD
• Greenville Health System

  • Emergency Medicine Physician
  • Seneca, SC
  • NPI 1033580444
  NPD
• Greenville Health System

  • General Acute Care Hospital
  • Simpsonville, SC
  • NPI 1679992838
  NPD
• Pathology Associates of Greenville PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Greenville, SC
  • NPI 1831151976
  NPD
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health-Upstate

  • Medically Fragile Infants and Children Day Care
  • Greenville, SC
  • NPI 1811439649
  NPD

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

• Lahey Clinic Hospital, Inc.

  • General Acute Care Hospital
  • Burlington, MA
  • NPI 1558392563
  Care Compare affiliation

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1619327285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018054210",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054210",
            "country_code": "US",
            "telephone_number": "864-455-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "KIMBERLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL2593",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MAYERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaela Kaliko Akemi Iwai
• Mallika Tara Iyer
• J & J Homecare LLC
• Nicole Jackson
• Susan M Jacob, MD
• Jeanne Marie Jacoby, FNP
• Mehrian Jafarizade, MD
• Nicole Annette Clarke Jagodowski
• Joyce Jahrling Devoe
• Jahrling Ocular Prosthetics, Inc.

• Physician Assistant in Burlington, MA
• Providers in Burlington, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.