Melissa C. Jacobs, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN2260951 Issued in MA

Practice address

801 Massachusetts Ave
Crosstown 6C
Boston, MA 02118-2526

Phone

(617) 414-5951

Fax

(617) 414-1577

NPI assigned

Jan 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Melissa C. Samler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1720401631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MASSACHUSETTS AVE",
            "address_2": "CROSSTOWN 6C",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-414-5951",
            "fax_number": "617-414-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "MELISSA",
        "middle_name": "C.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-28",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN2260951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110098913A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "SAMLER",
            "middle_name": "C.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Edward E Jacobs, M.D.
• Jacqueline Nicole Jacobs, MD, MPH
• Jamie M Jacobs, PHD
• Karen Jacobs, OTR
• Lanise Jacobs
• Sarah Alyse Jacobs, MD
• Shakeila Jacobs, LCSW
• Sharon L Jacobs, MD
• Uma Sarah Jacobs, MD
• Christina Marie Jacobsen, MD, PHD

• Gerontology Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Gerontology Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.