Alan Fisch, MD

Individual provider Active NPI Addiction Medicine (Psychiatry & Neurology) Physician · Cambridge, MA

NPI 1043239270 · NPPES record last updated Mar 3, 2015

Key facts

NPI
1043239270
Entity type
Individual (NPI type 1)
Primary specialty
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X
License
28176 (MA)
Practice address
872 Massachusetts Ave.
Ste. 2-2, 2-7
Cambridge, MA 02139
Phone
(617) 395-5806
Fax
(617) 383-6404
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 5

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.

Medicare Care Compare profile

Specialty
Psychiatry
Also: Neurology
Education
Tufts University School of Medicine, 1963
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Square Medical Group LLC (16 clinicians)

Practice addresses (Care Compare)

884 Washington St
FL1 Weymouth Primary Care and Counseling
Weymouth, MA 02189-1527
Phone (781) 812-1643

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20061204000398 MA Practitioner - Psychiatry
Practitioner - Neurology
9931108883 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Square Medical Group LLC Current
since Feb 17, 2020
Accepting new patients
Preventive Medicine Associates Past Accepting new patients
Brighton Family Practice, Inc Past Accepting new patients
Thrive Counseling LLC Past
since May 15, 2011
Accepting new patients
North Suffolk Community Services Inc. Past
since Oct 20, 1997
Accepting new patients

Locations

884 Washington St
Fl 1
Weymouth, MA 02189
Phone (781) 812-1643

884 Washington St
Fl 2
Weymouth, MA 02189
Phone (617) 447-2146

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 28176 MA Yes
Psychiatry Physician 2084P0800X 28176 MA

Addresses

Primary practice location

872 Massachusetts Ave.
Ste. 2-2, 2-7
Cambridge, MA 02139

Mailing address

1000 Jefferson St.
Ste. 2C
Lynchburg, VA 24504
Phone (617) 379-0496

Other providers in Cambridge, MA

All providers in Cambridge, MA · Addiction Medicine (Psychiatry & Neurology) Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.