Active NPI
Susan D Block, MD
- Psychiatry Physician
- Boston, MA
National Provider Identifier
1083681563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 43420
- Practice address
- 44 Binney St
Sw411
Boston, MA 02115-6013 - Phone
- (617) 632-6181
- Fax
- (617) 632-6180
- NPI assigned
- Mar 3, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 43420 | MA | Primary |
Addresses
Primary practice location
44 Binney St
Sw411
Boston, MA 02115-6013
Mailing address
44 Binney St
Sw411
Boston, MA 02115-6013
Phone (617) 632-6181
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2488260 | Other | CIGNA | |
| V05389 | Other | MA | BLUE CROSS BLUE SHIELD |
| V05389 | Other | BC ELECT | |
| 702287 | Other | TUFTS | |
| 260038158 | Other | RR MEDICARE DFCI | |
| 154534 | Other | HPHC DFCI ONLY | |
| 260038156 | Other | RR MEDICARE BINNEY MED | |
| V05389 | Other | INDEMNITY | |
| 0163996 | Medicaid | MA | |
| V05389 | Other | HMO BLUE | |
| 65517 | Other | FALLON COMM HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2020 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43420 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187049600000",
"number": "1083681563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 BINNEY ST",
"address_2": "SW411",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156013",
"telephone_number": "617-632-6181",
"fax_number": "617-632-6180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 BINNEY ST",
"address_2": "SW411",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156013",
"telephone_number": "617-632-6181",
"fax_number": "617-632-6180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOCK",
"first_name": "SUSAN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-03",
"last_updated": "2007-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "43420",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2488260",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "V05389",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC ELECT",
"identifier": "V05389",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "702287",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE DFCI",
"identifier": "260038158",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC DFCI ONLY",
"identifier": "154534",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE BINNEY MED",
"identifier": "260038156",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEMNITY",
"identifier": "V05389",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0163996",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO BLUE",
"identifier": "V05389",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMM HEALTH PLAN",
"identifier": "65517",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.