Individual provider Active NPI

Peter A Mosbach, PH.D.

  • Health Service Psychologist
  • Acton, MA
National Provider Identifier
1013904309
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
4495 Issued in MA
Practice address
468 Great Rd
Acton, MA 01720-4187
Phone
(978) 635-0509
Fax
(603) 415-3521
NPI assigned
Sep 30, 2005
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4495 MA
Clinical Neuropsychologist 103G00000X 4495 MA
Health Service Psychologist 103TH0100X 4495 MA Primary

Addresses

Primary practice location

468 Great Rd
Acton, MA 01720-4187

Mailing address

468 Great Rd
Acton, MA 01720-4102
Phone (978) 635-0509

Other identifiers 1

IdentifierTypeStateIssuer
0518107MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041203000365 MA Practitioner - Clinical Psychologist 1355306341 Practice locations: Acton, MA; Peabody, MA; Waltham, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10 Centennial Dr
East Entrance
Peabody, MA 01960-7900
Phone (978) 826-7230

468 Great Rd
Acton, MA 01720-4187
Phone 978635050922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4495MAMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Primary Care PLLC PastSince Jan 1, 2022 Accepting new patients
Pauline Gerson Clinical Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25226/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1013904309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204102",
            "telephone_number": "978-635-0509",
            "fax_number": "603-415-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204187",
            "telephone_number": "978-635-0509",
            "fax_number": "603-415-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSBACH",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4495",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "4495",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "4495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0518107",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

Verify at the official NPI Registry.