Individual provider Active NPI

Jeanne Jacobs, PT, PA-C

  • Medical Physician Assistant
  • Quincy, MA
National Provider Identifier
1770753022
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA4272 Issued in MA
Practice address
21 Totman St
First Floor
Quincy, MA 02169-7564
Phone
(617) 770-4167
Fax
(617) 770-0971
NPI assigned
Mar 3, 2008
Last updated
Nov 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA4272 MA Primary
Orthopedic Physical Therapist 2251X0800X 18146 MA

Addresses

Primary practice location

21 Totman St
First Floor
Quincy, MA 02169-7564

Mailing address

104 Quarry Street
First Floor
Quincy, MA 02169-7564
Phone (617) 770-4167

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120224000027 MA Practitioner - Physician Assistant 1850479957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

450 Brookline Ave
Boston, MA 02215-5418
Phone (617) 632-3000

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
65.04
Promoting interoperability
100
Improvement activities
40
Cost
69.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
18146MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Nov 8, 2016 Accepting new patients
J.B. Rehabilitation Associates, Inc Orthopedic PastSince May 11, 1999 Accepting new patients
JK Therapy Associates, LLC Past Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

Interoperability endpoints

  • Direct secure messaging: jacobs.jeanne.dfci@direct.partners.masshiway.net

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": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1770753022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 QUARRY STREET",
            "address_2": "FIRST FLOOR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697564",
            "telephone_number": "617-770-4167",
            "fax_number": "617-770-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TOTMAN ST",
            "address_2": "FIRST FLOOR",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697564",
            "telephone_number": "617-770-4167",
            "fax_number": "617-770-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JEANNE",
        "name_prefix": "Ms.",
        "credential": "PT, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4272",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MA",
            "license": "18146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.