| Professional Psychiatric Associates & Consultants Pc | |
|
16 Mica Ln Ste 101 Wellesley Hills MA 02481-1721 | |
| (781) 591-5221 | |
| (781) 235-6390 |
| Full Name | Professional Psychiatric Associates & Consultants Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 16 Mica Ln Ste 101, Wellesley Hills, Massachusetts |
| Authorized Official Name and Position | Douglas G Jacobs (PRESIDENT) |
| Authorized Official Contact | 7815915221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Psychiatric Associates & Consultants Pc 33 Lillian Way Wayland MA 01778-3030 Ph: (781) 591-5221 | Professional Psychiatric Associates & Consultants Pc 16 Mica Ln Ste 101 Wellesley Hills MA 02481-1721 Ph: (781) 591-5221 |
| NPI Number | 1295913747 |
|---|---|
| Provider Enumeration Date | 02/07/2008 |
| Last Update Date | 11/16/2023 |
| Certification Date | 11/16/2023 |
| Medicare PECOS PAC ID | 2365571155 |
|---|---|
| Medicare Enrollment ID | O20100604000257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295913747 | NPI | - | NPPES |
| M1439301 | Other | MA | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 34367 (Massachusetts) | Primary |
| Provider Name | Douglas Jacobs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497799076 PECOS PAC ID: 4082744875 Enrollment ID: I20100604000297 |
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