Jacob Louis Perriello

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Practice address

12 Drew Ave
Weymouth, MA 02189-2226

Phone

(781) 901-9523

NPI assigned

Feb 1, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Quincy Pediatric Associates Inc

  • Pediatrics Physician
  • Quincy, MA
  • NPI 1063582781
  NPD (past)

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1982102265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 DREW AVE",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021892226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 DREW AVE",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021892226",
            "telephone_number": "781-901-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRIELLO",
        "first_name": "JACOB",
        "middle_name": "LOUIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon J Pehrson, M.D.
• Katelyn Michelle Pento
• Kendall Percich, DPT, PT
• Milica Perosevic, MD
• Nikola Perosevic, M.D.
• Jeanine Marie Perrone
• Ronald Perry, DMD, MS
• Andee Adia Peters-Kurtz, LICSW
• Karen F Peterson, PA-C
• Khiem B Pham-Nguyen, DMD

• Primary Care Clinic/Center in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Primary Care Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.