Active NPI
John Rosario, PSY.D.
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1023191749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 7894
- Practice address
- 81 Grozier Rd
Cambridge, MA 02138-3314 - Phone
- (781) 648-2256
- Fax
- (617) 876-1230
- NPI assigned
- Oct 24, 2006
- Last updated
- Dec 10, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 7894 | MA | Primary |
Addresses
Primary practice location
81 Grozier Rd
Cambridge, MA 02138-3314
Mailing address
81 Grozier Rd
Cambridge, MA 02138-3314
Phone (781) 648-2256
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W06075 | Other | MA | BLUECROSS BLUESHIELD |
| 0500950 | Medicaid | MA |
Other names 1
- John Rosario-Perez
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Previously, effective Oct 1, 2016 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7894 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481328000000",
"number": "1023191749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 GROZIER RD",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021383314",
"telephone_number": "781-648-2256",
"fax_number": "617-876-1230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 GROZIER RD",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021383314",
"telephone_number": "781-648-2256",
"fax_number": "617-876-1230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSARIO",
"first_name": "JOHN",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2016-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "7894",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "W06075",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0500950",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JOHN",
"last_name": "ROSARIO-PEREZ",
"credential": "PSY.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.