Jacob Arash Pourati, DMD, MSD, CAGS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

20469 Issued in MA

Practice address

57 Concord Ave
Belmont, MA 02478-4027

Phone

(617) 484-2431

NPI assigned

Aug 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Belmont Dental Group

  • Dental Clinic/Center
  • Belmont, MA
  • NPI 1215073499
  NPD (past)
• Belmont Dental Group, LLC.

  • Dentist
  • Belmont, MA
  • NPI 1700596103
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740390541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LONGWOOD AVE APT 820",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465224",
            "telephone_number": "617-240-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 CONCORD AVE",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024784027",
            "telephone_number": "617-484-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURATI",
        "first_name": "JACOB",
        "middle_name": "ARASH",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD, CAGS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "20469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olga Popova, LICSW
• Charles William Popper, M.D.
• Hannah Potvin, M.D.
• Anne Poulin
• Stephane Poulin, M.D.
• Anna Precht, PSYD
• Premier Performance Physical Therapy and Sports Medicine, L.L.C.
• Bruce Heimburger Price, MD
• PT Specialties 781
• Sreelakshmi Pushpanadh

• Periodontics in Belmont, MA
• Providers in Belmont, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.