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DR. JACOB MICHAEL KAYLE LISTER MD, PHD
NPI 1063155588
Student in an Organized Health Care Education/Training Program in New Haven, CT

Active since April 14, 2022PECOS Enrolled
230 S FRONTAGE RD, NEW HAVEN, CT 06519(203) 737-7129 Get Directions Write a Review

NPPES record last updated: April 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jacob Michael Kayle Lister Md, Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACOB MICHAEL KAYLE LISTER MD, PHD (NPI 1063155588) is an individual student in an organized health care education/training program in New Haven, Connecticut and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063155588
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JACOB MICHAEL KAYLE LISTERCredential: MD, PHD
Location Address230 S FRONTAGE RDNew Haven, CT 06519-1124
Mailing Address230 S Frontage RdNew Haven, CT 06519-1124 · (203) 737-7129
Phone(203) 737-7129
Sole ProprietorYes
Enumeration DateApril 14, 2022
NPPES CertifiedApril 14, 2022
✔ NPI 1063155588 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
230 S FRONTAGE RD, New Haven, CT 06519
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jacob Michael Kayle Lister Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEVIN COLEMAN
Psychologist (Clinical Child & Adolescent)
230 S FRONTAGE RD
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-6521
DR. KARIM IBRAHIM
Psychologist (Clinical Child & Adolescent)
230 S FRONTAGE RD
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 390-9981
PAULA POWE
Psychiatry & Neurology (Child & Adolescent Psychiatry)
230 S FRONTAGE RD
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (860) 961-6835
MR. KARTIK PATTABIRAMAN M.D., PH.D.
Psychiatry & Neurology (Psychiatry)
230 S FRONTAGE RD, YALE CHILD STUDY CENTER
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-2516
DR. JOSE MANUEL PAEZ MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
230 S FRONTAGE RD
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 848-5599
REBECCA DOGGETT PH.D.
Psychologist (Clinical Child & Adolescent)
230 S FRONTAGE RD
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-2548
REBECCA KAMODY MS
Psychologist (Clinical Child & Adolescent)
230 S FRONTAGE RD
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-7809
ROBERT LABRIL M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
230 S FRONTAGE RD
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 688-5997

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Lister's NPI number?

The NPI number for Jacob Lister is 1063155588. It was assigned to this individual provider in the NPPES registry on April 14, 2022.

Where is Jacob Lister located?

Jacob Lister practices at 230 S Frontage Rd, New Haven, CT 06519. The listed phone number is (203) 737-7129.

What is Jacob Lister's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Lister enrolled in Medicare?

Yes. Jacob Lister is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Lister was last updated on April 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.