Jacob W Soucy, PA-S

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

716 Stevens Ave
Portland, ME 04103-2693

Phone

(297) 283-0171

NPI assigned

May 1, 2019

Last updated

May 1, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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 ME

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1669423380
  Medicare reassignment NPD
• Mainegeneral Medical Center

  dba MaineGeneral Pharmacy

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1891359295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032693",
            "telephone_number": "297-283-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032693",
            "telephone_number": "297-283-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUCY",
        "first_name": "JACOB",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Sorensen
• Margaret Tekla Soroka, M.D.
• Cynthia Sortwell, M.D.
• Lora Soucy Moreau, OTR/L
• Ashley Dawn Soucy, LD
• Jennifer Anne Soucy, PHARMD
• Soul Sanctuary, LLC
• Helen M Soule, MD
• Soundings Therapy Group, PLLC
• Jordan Kelly Sountis, AGACNP

• Student in an Organized Health Care Education/Training Program in Portland, ME
• Providers in Portland, ME by specialty
• Student in an Organized Health Care Education/Training Program in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.