Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob F. Kallenberg

Individual provider Emergency Medicine Physician · NPI 1093125171

Jacob F. Kallenberg is an Emergency Medicine in Brockton, Massachusetts. Graduated from University of Cincinnati College of Medicine in 2014, 12 years ago. Practices with Bmc Affiliated Physicians, Inc, a 545-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
12
Trained at
University of Cincinnati College of Medicine
Licensed in
MA
In the registry since
2014
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Practice location Address checks out

235 N Pearl St
Brockton, MA 02301-1794
Phone: (508) 427-3075
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 55 Fogg Rd, Weymouth, MA 02190-2432 — (781) 624-8000

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 277504 (MA)

Record details

NPI number1093125171
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 29, 2014
Last updated in NPPESMarch 10, 2025
Certification dateMarch 10, 2025
Mailing address41 Saint Marys Rd, Milton, MA 02186-2034

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolUNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Bmc Affiliated Physicians, Inc. — 545 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Brockton