Individual provider Active NPI

James M. Donovan, PHD

  • Psychologist
  • Wellesley, MA
National Provider Identifier
1013961051
Registry record updated Mar 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
184 Issued in MA
Practice address
230 Worcester St
Wellesley, MA 02481-5420
Phone
(781) 431-5270
Fax
(781) 431-5535
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 184 MA Primary

Addresses

Primary practice location

230 Worcester St
Wellesley, MA 02481-5420

Mailing address

230 Worcester St
Wellesley, MA 02481-5420
Phone (781) 431-5270

Other identifiers 3

IdentifierTypeStateIssuer
W01086OtherMABLUE CROSS
0014267OtherMANEIGHBORHOOD HEALTH PLAN
669500OtherMATUFTS HEALTH PLAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdonovanphd5881@direct.atrius.masshiway.net

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
I20031126000611 MA Practitioner - Clinical Psychologist 9436054848

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615075200000",
    "number": "1013961051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815420",
            "telephone_number": "781-431-5270",
            "fax_number": "781-431-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815420",
            "telephone_number": "781-431-5270",
            "fax_number": "781-431-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "JAMES",
        "middle_name": "M.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "W01086",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0014267",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "669500",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdonovanphd5881@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "230 Worcester St",
            "city": "Wellesley",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024815420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.