Individual provider Active NPI

Barry Jacobs, PSY.D

  • Psychologist
  • Springfield, PA
National Provider Identifier
1760588701
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS006132L Issued in PA
Practice address
1260 E Woodland Ave
Suite 200
Springfield, PA 19064-3969
Phone
(610) 690-4490
Fax
(610) 328-9391
NPI assigned
Sep 16, 2006
Last updated
Oct 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS006132L PA Primary

Addresses

Primary practice location

1260 E Woodland Ave
Suite 200
Springfield, PA 19064-3969

Mailing address

1260 E Woodland Ave
Suite 200
Springfield, PA 19064-3969
Phone (610) 690-4490

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
I20040818000807 PA Practitioner - Clinical Psychologist 0244203149 Reassigns benefits to 1 organization
Practice locations: Swarthmore, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Hahnemann University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

211 Monroe St
Second Floor
Media, PA 19063-3019

304 Chestnut Ave
Swarthmore, PA 19081-1405
Phone (610) 604-4423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS006132LPAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients

Locations

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

1260 E Woodland Ave
Ste 200
Springfield, PA 19064
Phone (610) 690-4471

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1760588701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 E WOODLAND AVE",
            "address_2": "SUITE 200",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643969",
            "telephone_number": "610-690-4490",
            "fax_number": "610-328-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 E WOODLAND AVE",
            "address_2": "SUITE 200",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643969",
            "telephone_number": "610-690-4490",
            "fax_number": "610-328-9391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS006132L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.