Individual provider Active NPI

Catherine Ann Jakubowitch, M.D.

  • Psychiatry Physician
  • Portland, ME
National Provider Identifier
1891804415
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
014735 Issued in ME
Practice address
69 Federal St
2ND Floor
Portland, ME 04101-4260
Phone
(207) 775-0110
Fax
(207) 772-7702
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 014735 ME Primary

Addresses

Primary practice location

69 Federal St
2ND Floor
Portland, ME 04101-4260

Mailing address

69 Federal St
2ND Floor
Portland, ME 04101-4260
Phone (207) 775-0110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Jefferson Medical College of Thomas Jefferson University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 328
Yarmouth, ME 04096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
014735MEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pat Chanterelle LLC PastSince May 15, 2012 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1891804415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 FEDERAL ST",
            "address_2": "2ND FLOOR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014260",
            "telephone_number": "207-775-0110",
            "fax_number": "207-772-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 FEDERAL ST",
            "address_2": "2ND FLOOR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014260",
            "telephone_number": "207-775-0110",
            "fax_number": "207-772-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKUBOWITCH",
        "first_name": "CATHERINE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "014735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.