DR. MICHELLE CARLEY JACOBO PHD
NPI 1194798769
Psychologist in Boston, MA

Active since February 13, 2006PECOS EnrolledAccepts Medicare Assignment
55 FRUIT ST, WARREN 1220, BOSTON, MA 02114(617) 724-9119 Get Directions Write a Review

NPPES record last updated: June 26, 2014. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Michelle Carley Jacobo Phd NPPES

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

DR. MICHELLE CARLEY JACOBO PHD (NPI 1194798769) is an individual psychologist in Boston, Massachusetts, licensed in Massachusetts (7365) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1994).

NPPES Registry Identity

NPI1194798769
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. MICHELLE CARLEY JACOBOCredential: PHD
Location Address55 FRUIT ST, WARREN 1220Boston, MA 02114-2621
Mailing AddressPo Box 9142Charlstown, MA 02129-9142 · (617) 724-9119
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateFebruary 13, 2006
Last NPPES UpdateJune 26, 2014
✔ NPI 1194798769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MA · 7365
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
55 FRUIT ST, Boston, MA 02114

Other Identifiers 5

Other723413MA · Tufts Health Plan
OtherW06093MA · Bcbs Ma
Medicaid0500259MA
Medicare PINWW3009MA
Medicare UPINP15181

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michelle Carley Jacobo Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850389669
PECOS Enrollment IDI20040714000129
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Michelle Jacobo reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Dermatology
55 FRUIT ST, BUL 2
Boston, MA 02114
  • Reassigned Medicare billing, Massachusetts enrollment
  • 6,360 clinicians in this Medicare group
General Acute Care Hospital
55 FRUIT ST, BULFINCH 360
Boston, MA 02114
  • Reassigned Medicare billing, Massachusetts enrollment
  • 6,234 clinicians in this Medicare group
Internal Medicine
75 FRANCIS ST
Boston, MA 02115
  • Reassigned Medicare billing, Massachusetts enrollment
  • 4,574 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114

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 Michelle Jacobo's NPI number?

The NPI number for Michelle Jacobo is 1194798769. It was assigned to this individual provider in the NPPES registry on February 13, 2006.

Where is Michelle Jacobo located?

Michelle Jacobo practices at 55 Fruit St Warren 1220, Boston, MA 02114. The listed phone number is (617) 724-9119.

What is Michelle Jacobo's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Michelle Jacobo enrolled in Medicare?

Yes. Michelle Jacobo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Michelle Jacobo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michelle Jacobo reassigns Medicare benefits to 3 organizations: Massachusetts General Physicians Organization Inc (Boston, MA), The General Hospital Corporation (Boston, MA) and Brigham & Womens Physicians Organization Inc (Boston, MA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Michelle Jacobo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michelle Jacobo accept?

Health plans from Harvard Pilgrim Health Care, Taro Health and WellSense Health Plan list Michelle Jacobo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michelle Jacobo was last updated on June 26, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.