Active NPI
David Maclutsky
- Specialist
- Amherst, MA
National Provider Identifier
1073055778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1194
- Practice address
- 131 Commonwealth Ave
Amherst, MA 01003-9253 - Phone
- (413) 545-1760
- NPI assigned
- Nov 11, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 1194 | MA | Primary |
Addresses
Primary practice location
131 Commonwealth Ave
Amherst, MA 01003-9253
Mailing address
15 Dressel Ave
Belchertown, MA 01007-9468
Phone (413) 230-2028
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1194 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478822400000",
"number": "1073055778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 DRESSEL AVE",
"city": "BELCHERTOWN",
"state": "MA",
"postal_code": "010079468",
"telephone_number": "413-230-2028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 COMMONWEALTH AVE",
"city": "AMHERST",
"state": "MA",
"postal_code": "010039253",
"telephone_number": "413-545-1760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACLUTSKY",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-11",
"last_updated": "2016-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MA",
"license": "1194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amherst, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.