Active NPI
Edward E Jacobs, M.D.
- Otolaryngology/Facial Plastic Surgery Physician
- Boston, MA
National Provider Identifier
1629268768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology/Facial Plastic Surgery Physician
- License
- 33730
- Practice address
- 243 Charles St
9TH Floor
Boston, MA 02114-3002 - Phone
- (617) 331-1541
- NPI assigned
- Jul 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | 33730 | MA | Primary |
Addresses
Primary practice location
243 Charles St
9TH Floor
Boston, MA 02114-3002
Mailing address
149 Lane Rd
Chester, NH 03036-4023
Phone (617) 331-1541
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33730 | MA | MD | Otolaryngology/Facial Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185321600000",
"number": "1629268768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 LANE RD",
"city": "CHESTER",
"state": "NH",
"postal_code": "030364023",
"telephone_number": "617-331-1541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 CHARLES ST",
"address_2": "9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021143002",
"telephone_number": "617-331-1541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "EDWARD",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-25",
"last_updated": "2007-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "MA",
"license": "33730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.