Individual provider Active NPI

Charles Nicholas Billikas, PSY.D.

  • Clinical Psychologist
  • Walpole, MA
National Provider Identifier
1023230372
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6302 Issued in MA
Practice address
841 Main St
Suite 4
Walpole, MA 02081-2997
Phone
(508) 498-0766
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6302 MA Primary

Addresses

Primary practice location

841 Main St
Suite 4
Walpole, MA 02081-2997

Mailing address

171 Brook Street
Franklin, MA 02038
Phone (508) 498-0766

Other identifiers 2

IdentifierTypeStateIssuer
0522287MedicaidMA
W05073OtherMABLUE CROSS BLUE SHIELD

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
I20160727001484 MA Practitioner - Clinical Psychologist 3971825803 Practice locations: Walpole, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

869 Main St
Suite 7
Walpole, MA 02081-2985
Phone (508) 498-0766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6302MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Isaacs & Associates Clinical Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1023230372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 BROOK STREET",
            "city": "FRANKLIN",
            "state": "MA",
            "postal_code": "02038",
            "telephone_number": "508-498-0766",
            "fax_number": "508-668-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 MAIN ST",
            "address_2": "SUITE 4",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020812997",
            "telephone_number": "508-498-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLIKAS",
        "first_name": "CHARLES",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0522287",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W05073",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walpole, MA

Sources for this page

Verify at the official NPI Registry.