Dr. Brian C. Jacobson
Internal Medicine (Gastroenterology)

Address: 830 Harrison Avenue, Moakley, 2nd Floor, Boston, MA 02118-2905
Phone: 6176386525

Dr. Brian C. Jacobson (NPI# 1255389821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1255389821
Entity Type Individual
Full Name Dr. Brian C. Jacobson
Credential MD, MPH
Gender Male
Practice Address 830 Harrison Avenue
Moakley, 2nd Floor
Boston
MA 02118-2905
Practice Telephone 6176386525
Practice Fax Number 6156387448
Mailing Address 720 Harrison Avenue
Dob 503
Boston
MA 02118
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-05-05
Last Update Date 2014-06-04

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
No 207R00000X Internal Medicine Allopathic & Osteopathic Physicians 153606 MA
Yes 207RG0100X Internal Medicine · Gastroenterology Allopathic & Osteopathic Physicians 153606 MA

Other Provider Identifier

State Identifier Issuer Type Code
MA 110060654A MEDICAID

Other Providers BRIAN JACOBSON

NPI Name Taxonomy Address Enumeration
1851877930 Brian Jay Jacobson Physician Assistant 465 N 700 W, Provo, UT 84601-2649 2018-07-12
1023202546 Brian Morse Jacobson Military Health Care Provider Mcm Crew Reaper, Fpo, AE 09501 1905 2007-08-28
1215422910 Brian Jacobson Physical Therapy Assistant 100 Glenview Pl, Naples, FL 34108-3137 2018-06-25
1093065336 Brian Edwin Jacobson Physical Therapist 500 Paseo Camarillo, Suite 105, Camarillo, CA 93010-5900 2012-09-13
1326255381 Brian Jacobson Dentist 31550 Schoolcraft Rd, Livonia, MI 48150-1805 2007-05-17
1730305202 Brian Jacobson Psychologist 26 W 9th St, Suite 5c, New York, NY 10011-8971 2007-04-17

Physician Overview

NPI 1255389821
PAC ID by PECOS 0840387254
Professional Enrollment ID I20071101000433
Full Name Brian Jacobson
Organization Legal Name EVANS MEDICAL FOUNDATION INC
Gender M
Medical School ALBERT EINSTEIN COLLEGE OF MEDICINE OF YESHIVA UNIVERSITY
Graduation Year 1995
Primary Specialty GASTROENTEROLOGY
Secondary Specialties INTERNAL MEDICINE
Group Practice PAC ID 7416946546
Number of Group Practice Members 364
Accepts Medicare Assignment Y
Report Quality Measures Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
220031 BOSTON MEDICAL CENTER

Office Location

Street Address 830 HARRISON AVENUE
MOAKLEY, 2ND FLOOR
City BOSTON
State MA
Zip Code 02118-2905

Providers in the same location

NPI Name Taxonomy Address Enumeration
1316929342 Jennifer F Tseng Surgery 830 Harrison Avenue, Moakley, Suite 3400, Boston, MA 02118 2005-11-16
1629569702 Kelsey Jean Burke Physician Assistant 830 Harrison Avenue, Moakley, Suite 3400, Boston, MA 02118 2018-05-23
1336697382 Samuel Robert Lajoie Physician Assistant 830 Harrison Avenue, Moakley, Suite 3500, Boston, MA 02118 2016-09-20
1790148864 Charlene Julien Nurse Practitioner 830 Harrison Avenue, Moakley, 2nd Floor, Boston, MA 02118-2335 2016-04-05
1740640739 Nicholas Peter Simms Physician Assistant 830 Harrison Avenue, Suite 1400, Boston, MA 02118-2784 2016-03-03
1699150938 Brandy Nichole Kenner Keefe Nurse Practitioner 830 Harrison Avenue, Suite 1400, Boston, MA 02118 2015-07-28
1780018077 Kimberly Ann Nehiley Nurse Practitioner 830 Harrison Avenue, Moakley, 3rd Floor, Boston, MA 02118 2013-08-22
1225375314 Susan Catherine Griever Nurse Practitioner 830 Harrison Avenue, Suite 1400, Boston, MA 02118 2013-01-09
1598014979 Uma R. Phatak Surgery 830 Harrison Avenue, Moakley, Suite 3400, Boston, MA 02118-2905 2012-08-31
1851659130 Michael Dyer Radiology 830 Harrison Avenue, Moakley Ll100, Boston, MA 02118-2905 2012-04-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1467910695 Alice Ma Student in an Organized Health Care Education/Training Program Department of Radiology 820 Harrison Ave Fgh Building, 4th Floor, Boston, MA 02118 2019-03-06
1851857338 Ruth Madeline Mateo Nurse Practitioner 30 Northhampton Street, Boston, MA 02118 2019-02-20
1952874737 Boston University Medical Center Anesthesiologists, Inc. Anesthesiology 750 Albany St, Power Plant 2r, Boston, MA 02118 2019-01-04
1205311966 Jacqueline Husid Social Worker 1313washingtonst., Uniy 707, Boston, MA 02118 2018-09-28
1902380363 Bryan David Godduhn-braaten Nurse Practitioner 830 Harrison Ave, Suite 3500, Boston, MA 02118 2018-09-21
1710469176 Brunilda Torres Social Worker 566 Columbus Ave, Boston, MA 02118 2018-09-02
1528549425 Adekemi Victoria Adeleye Registered Nurse 725 Albany St Ste 5b, Boston, MA 02118 2018-08-28
1245718576 Sateesh Jayappa Radiology 820, Harrison Ave, Deaprtment of Radiology, Fgh Building, 3rd Floor, Boston, MA 02118 2018-07-30
1982181715 Camila Souza Alves Cosmo Student in an Organized Health Care Education/Training Program 771 Albany St Ste 3314, Boston, MA 02118 2018-07-24
1871070144 Giuseppe Orlando Orthopaedic Surgery 850 Harrison Avenue, Dowling 2 North Bme, Boston, MA 02118 2018-07-19
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Taxonomy Information

Taxonomy Code 207RG0100X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Gastroenterology

Taxonomy Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861913881 Aymeric Becq Internal Medicine 330 Brookline Avenue, Dana 603, Boston, MA 02215 2017-06-29
1386019503 Boston Food Allergy Center LLC Internal Medicine 65 Harrison Ave Ste 201, Boston, MA 02111-1924 2015-12-14
1487908141 Jose Manuel Mella Internal Medicine 330 Brookline Ave Da 501, East Campus, Beth Israel Deaconess Medical Center, Boston, MA 02215-5403 2012-11-02
1003169327 Rong J Guan, Md LLC Internal Medicine 30 Kneeland St Fl 5, Boston, MA 02111-1528 2012-10-24
1124317235 Vikram Rangan Internal Medicine 330 Brookline Ave # Dana501, Boston, MA 02215 2011-03-30
1043479587 Vilas R Patwardhan Internal Medicine 110 Francis St, Suite 8e, Beth Israel Deaconess Medical Center, Boston, MA 02215 2008-06-09
1508080060 Daisy De-peralta-daly Internal Medicine 389 Commonwealth Ave, Boston, MA 02115-1802 2007-04-13
1043306558 Harry T Anastopoulos Internal Medicine 110 Francis St Suite 8e, Boston, MA 02215 2006-10-04
1851406813 Ciaran P Kelly Internal Medicine Bi/deaconess Medical Ctr, 330 Brookline Avenue, Boston, MA 02215 2006-08-20
1417981184 Stanley J Rosenberg Internal Medicine Beth Israel Deaconess Hospital, 330 Brookline Ave, Boston, MA 02215 2006-07-10
Find all providers in BOSTON

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City BOSTON
Zip Code 02118

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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