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

Jacob Poulose, MD

Individual provider Internal Medicine Physician · NPI 1578723508

Jacob Poulose, MD is an Internal Medicine in Northridge, California. Qualified in 2007, 19 years ago. Practices with Papr, a 2-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
19
Licensed in
CA
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

8349 Reseda Blvd Ste G
Northridge, CA 91324-5914
Phone: (818) 886-5827
Fax: (818) 775-9351
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence A113557 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence A113557 (CA)

Record details

NPI number1578723508
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 12, 2008
Last updated in NPPESJanuary 11, 2022
Certification dateJanuary 11, 2022
Mailing address8349 Reseda Blvd Ste G, Northridge, CA 91324-5914

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Also practisesNEPHROLOGY
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Papr — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Northridge