Individual provider Active NPI

Robert C Cross, ED.D.

  • Clinical Psychologist
  • Lynn, MA
National Provider Identifier
1104827559
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4068 Issued in MA
Practice address
225 Boston St
Suite 306
Lynn, MA 01904-3137
Phone
(617) 362-3139
Fax
(781) 592-3796
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 4068 MA Primary

Addresses

Primary practice location

225 Boston St
Suite 306
Lynn, MA 01904-3137

Mailing address

5 Babson St
Unit 3
Gloucester, MA 01930-3604
Phone (978) 282-7452

Other identifiers 1

IdentifierTypeStateIssuer
0517011MedicaidMA

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
I20120404000184 MA Practitioner - Clinical Psychologist 9032379748 Practice locations: Gloucester, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Boston University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5 Babson St
Unit 3
Gloucester, MA 01930-4076
Phone (781) 586-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104827559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BABSON ST",
            "address_2": "UNIT 3",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019303604",
            "telephone_number": "978-282-7452",
            "fax_number": "781-598-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BOSTON ST",
            "address_2": "SUITE 306",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019043137",
            "telephone_number": "617-362-3139",
            "fax_number": "781-592-3796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSS",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0517011",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.