NPIMap

Individual provider Active NPI

Caren G Jacobson, MD

  • Family Medicine Physician
  • Lawrence, MA
National Provider Identifier
1992797245
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
72992 Issued in MA
Practice address
150 Park St
Lawrence, MA 01841-2517
Phone
(978) 685-1770
Fax
(978) 682-5787
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 72992 MA Primary

Addresses

Primary practice location

150 Park St
Lawrence, MA 01841-2517

Mailing address

150 Park St
Lawrence, MA 01841-2517
Phone (978) 685-1770

Other identifiers 1

IdentifierTypeStateIssuer
1303775MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041007000328 MA Practitioner - Family Practice 8325007107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Lawrence Family Health Center IncGroup PAC ID 0446221956, 118 clinicians

Practice addresses (Care Compare)

34 Haverhill St
Lawrence, MA 01841-2884
Phone (978) 686-0090

Hospital & facility affiliations

  • Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72992MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lawrence Family Health Center, Inc. Current Accepting new patients
Greater Lawrence Family Health Center Inc. CurrentSince Sep 1, 2004 Accepting new patients
Greater Lawrence Family Health Center Inc CurrentSince Sep 1, 2004 Accepting new patients
Lawrence General Hospital Past Accepting new patients

Locations

150 Park St
Lawrence, MA 01841
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841

Interoperability endpoints

  • Direct secure messaging: caren.jacobson.1@23857.direct.athenahealth.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394496000000",
    "number": "1992797245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PARK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412517",
            "telephone_number": "978-685-1770",
            "fax_number": "978-682-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PARK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412517",
            "telephone_number": "978-685-1770",
            "fax_number": "978-682-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "CAREN",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2014-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "72992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303775",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.