Individual provider Active NPI

Donald L. Angell, PH.D.

  • Clinical Psychologist
  • Quincy, MA
National Provider Identifier
1093868077
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2003 Issued in MA
Practice address
111 Willard St
Quincy, MA 02169-1200
Phone
(617) 471-9990
NPI assigned
Jan 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2003 MA
Addiction (Substance Use Disorder) Psychologist 103TA0400X 2003 MA
Adult Development & Aging Psychologist 103TA0700X 2003 MA
Clinical Psychologist 103TC0700X 2003 MA Primary
Counseling Psychologist 103TC1900X 2003 MA
Family Psychologist 103TF0000X 2003 MA
Health Service Psychologist 103TH0100X 2003 MA
Intellectual & Developmental Disabilities Psychologist 103TM1800X 2003 MA
Rehabilitation Psychologist 103TR0400X 2003 MA

Addresses

Primary practice location

111 Willard St
Quincy, MA 02169-1200

Mailing address

111 Willard St
Quincy, MA 02169-1200
Phone (617) 471-9990

Other identifiers 2

IdentifierTypeStateIssuer
WO2184OtherMABLUE CROSS
026023OtherMAAETNA

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
I20100422001061 MA Practitioner - Clinical Psychologist 6709911209 Practice locations: Duxbury, MA; Quincy, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20 Tremont St
Suite 15
Duxbury, MA 02332-5315
Phone (781) 934-0953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2003MAMDRehabilitation Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427932800000",
    "number": "1093868077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WILLARD ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691200",
            "telephone_number": "617-471-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WILLARD ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691200",
            "telephone_number": "617-471-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELL",
        "first_name": "DONALD",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-21",
        "last_updated": "2015-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "2003",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "2003",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MA",
            "license": "2003",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2003",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "2003",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MA",
            "license": "2003",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "2003",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MA",
            "license": "2003",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MA",
            "license": "2003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "WO2184",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "026023",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.