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JACOB POULOSE MD.
NPI 1578723508
Internal Medicine - Nephrology in Northridge, CA

Active since June 12, 2008PECOS EnrolledAccepts Medicare Assignment
8349 RESEDA BLVD STE G, NORTHRIDGE, CA 91324(818) 886-5827(818) 775-9351 Get Directions Write a Review

NPPES record last updated: January 11, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Jacob Poulose Md. NPPES

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

JACOB POULOSE MD. (NPI 1578723508) is an individual nephrology provider in Northridge, California, licensed in California (A113557) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1578723508
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameJACOB POULOSECredential: MD.
Location Address8349 RESEDA BLVD STE GNorthridge, CA 91324-5914
Mailing Address8349 Reseda Blvd Ste GNorthridge, CA 91324-5914 · (818) 886-5828 · Fax (818) 775-9351
Phone(818) 886-5827
Fax(818) 775-9351
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateJune 12, 2008
Last NPPES UpdateJanuary 11, 2022
NPPES CertifiedJanuary 11, 2022
✔ NPI 1578723508 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in CA · A113557
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X · License A113557 (CA)
8349 RESEDA BLVD STE G, Northridge, CA 91324
Open in Google Maps ↗

Other Identifiers 1

Medicaid00A1135570CA

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

Jacob Poulose Md. 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 ID5496942377
PECOS Enrollment IDI20101203000796
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 Reassignment

Medicare enrollment records show Jacob Poulose reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Papr
Same address
Nephrology
8349 RESEDA BLVD STE G
Northridge, CA 91324
  • Reassigned Medicare billing, California enrollment
  • 2 clinicians in this Medicare group
NPI 1295433415 (818) 886-7300

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

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
687 services164 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
149 services44 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
147 services39 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
142 services112 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
127 services59 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
123 services56 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91324 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims360 services$4.15 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims5,136 services$0.48 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 3

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

RENEE DUA MD, A PROFESSIONAL MEDICAL CORPORATION
Internal Medicine (Nephrology)
8349 RESEDA BLVD STE G
NORTHRIDGE, CA 91324
Los Angeles County (323) 682-9246
PAPR
Internal Medicine (Nephrology)
8349 RESEDA BLVD STE G
NORTHRIDGE, CA 91324
Los Angeles County (818) 886-7300
NORTHRIDGE FREE CLINIC
Internal Medicine (Nephrology)
8349 RESEDA BLVD STE G
NORTHRIDGE, CA 91324
Los Angeles County (818) 886-7322

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 Poulose's NPI number?

The NPI number for Jacob Poulose is 1578723508. It was assigned to this individual provider in the NPPES registry on June 12, 2008.

Where is Jacob Poulose located?

Jacob Poulose practices at 8349 Reseda Blvd Ste G, Northridge, CA 91324. The listed phone number is (818) 886-5827.

What is Jacob Poulose's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Jacob Poulose enrolled in Medicare?

Yes. Jacob Poulose 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 organization bills Medicare for Jacob Poulose's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Poulose reassigns Medicare benefits to Papr (Northridge, CA). The 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 Jacob Poulose's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jacob Poulose was last updated on January 11, 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.