CMS-1500 Box 24J / 33a • NPI
1821618489
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363AM0700X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical
Box 32 Service Location & ZIP+4
40 WRIGHT ST, PALMER, MA, 01069-1138
✓ 9-Digit EDI 837 ZIP+4 (01069-1138)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1821618489 (JACOB BAMFORD COBLYN, PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1821618489)
Medicare Beneficiaries
238
Total Billed Services
543
Distinct CPT/HCPCS Codes
18
Medicare Allowed Total
$42,133.27
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 242 |
99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 16 |
99441 | Telephone medical discussion with physician, 5-10 minutes | 19 |
99442 | Telephone medical discussion with physician, 11-20 minutes | 46 |
99443 | Telephone medical discussion with physician, 21-30 minutes | 35 |
99497 | Advance care planning, first 30 minutes | 13 |
G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 73 |
G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 53 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Advair Hfa Fluticasone Propion/Salmeterol | 19 | <11 |
| Albuterol Sulfate Hfa Albuterol Sulfate | 42 | 17 |
| Allopurinol Allopurinol | 26 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 163 | 47 |
| Amlodipine Besylate-Benazepril Amlodipine Besylate/Benazepril | 16 | <11 |
| Atenolol Atenolol | 30 | <11 |
| Atorvastatin Calcium Atorvastatin Calcium | 190 | 60 |
| Baclofen Baclofen | 16 | <11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1821618489 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JACOB BAMFORD COBLYN, PA |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical NUCC Code: 363AM0700X (Physician Assistant, Medical) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 40 WRIGHT ST, PALMER, MA, 01069-1138 |
| Practice Telephone / Fax | Tel: (413) 370-5400 | Fax: (413) 370-5654 |
| Administrative Mailing Address | 280 CHESTNUT ST FL 2, SPRINGFIELD, MA, 01199-1001 |
| Enumeration & Last Sync | Enumerated: 2020-04-23 | CMS Record Updated: 2021-08-30 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363AM0700X)
What Does Taxonomy Code 363AM0700X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363AM0700X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JACOB BAMFORD COBLYN, PA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
390200000X — Student in an Organized Health Care Education/Training ProgramPlain English: Licensed & Credentialed Student in an Organized Health Care Education/Training Program | State: N/A | License: Verified | Primary: Secondary |
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: MA | License: PA8016 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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