Anoopa Mathew Jacob, DNP, ARNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP61229264 Issued in WA

Practice address

1330 Rockefeller Ave Ste 140
Everett, WA 98201-1682

Phone

(425) 261-4210

NPI assigned

Oct 27, 2021

Sex

Female

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 WA

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• Providence Health & Services- Washington

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  Medicare reassignment Care Compare group NPD
• Blossom Mental Health Services, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Everett, WA
  • NPI 1003596412
  Medicare reassignment NPD
• New Era Mental Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynnwood, WA
  • NPI 1073198602
  Medicare reassignment
• Providence Health & Services - Washington

  • Family Medicine Physician
  • Marysville, WA
  • NPI 1063663458
  NPD

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

{
    "created_epoch": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1982368767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE STE 140",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011682",
            "telephone_number": "425-261-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE STE 140",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011682",
            "telephone_number": "425-261-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ANOOPA",
        "middle_name": "MATHEW",
        "credential": "DNP, ARNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61229264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Bernard Jackson Jr., MSW, CLINICIAN 2
• Sarah L Jackson, LICSW
• Tionna Marie Jackson
• Whitney Gwendolyn Jackson, MA, LMHC, DCR
• William Chance Jackson
• Anne M Jacobs
• Beth Jacobs
• Joshua Lane Jacobs, BS
• Michelle Jacobs, D.O., MPH
• Debra Ann Jacobsen, LMT

• Psychiatric/Mental Health Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.