JACOB LUKE VARELA PSYD
NPI 1699585190
Clinical Neuropsychologist in Providence, RI

Q: What is Jacob Varela's NPI number?

The NPI number for Jacob Varela is 1699585190. It was assigned to this individual provider in the NPPES registry on January 8, 2025.

Q: What is Jacob Varela's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Varela was last updated on June 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.

Active since January 08, 2025PECOS Enrolled

345 BLACKSTONE BLVD STE 2, PROVIDENCE, RI 02906(844) 401-0111 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Jun 17, 2025, Jan 8, 2025 (2 updates tracked since 2025).

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About Jacob Luke Varela Psyd NPPES

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

JACOB LUKE VARELA PSYD (NPI 1699585190) is an individual clinical neuropsychologist in Providence, Rhode Island, licensed in Rhode Island (PS02308) and active in the NPI registry since January 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699585190

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameJACOB LUKE VARELACredential: PSYD

Location Address345 BLACKSTONE BLVD STE 2Providence, RI 02906-4829

Mailing Address455 Toll Gate Rd, Prc And CredentialingWarwick, RI 02886-2759 · (401) 273-0641 · Fax (401) 273-2919

Phone(844) 401-0111

Sole ProprietorNo

Enumeration DateJanuary 8, 2025

Last NPPES UpdateJune 17, 20252 updates tracked since enumeration

NPPES CertifiedJune 17, 2025

✔ NPI 1699585190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in RI · PS02308

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

345 BLACKSTONE BLVD STE 2, Providence, RI 02906

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Luke Varela Psyd 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.

MARK IANNUCCILLI LMHC

Counselor (Mental Health)