Individual provider Active NPI

Karen Jakubowski

  • Clinical Psychologist
  • Pittsburgh, PA
National Provider Identifier
1710460738
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS019254 Issued in PA
Practice address
3811 Ohara St
Pittsburgh, PA 15213-2561
Phone
(716) 480-0412
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS019254 PA Primary

Addresses

Primary practice location

3811 Ohara St
Pittsburgh, PA 15213-2561

Mailing address

3811 Ohara St
Pittsburgh, PA 15213-2561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211214002119 PA Practitioner - Clinical Psychologist 2860882438 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS019254PAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Advanced Practice Providers CurrentSince Feb 1, 2022 Accepting new patients
Upmc Advanced Practice Providers CurrentSince Feb 1, 2022 Accepting new patients

Locations

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

200 Lothrop St
Ste 10055B
Pittsburgh, PA 15213
Phone (412) 864-0594

Interoperability endpoints

  • Direct secure messaging: karen.jakubowski@upmcdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1710460738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 OHARA ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 OHARA ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132561",
            "telephone_number": "716-480-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKUBOWSKI",
        "first_name": "KAREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS019254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.