Individual provider Active NPI

Thomas Francis Obrien, MA MSW LICSW

  • Psychologist
  • Brewster, MA
National Provider Identifier
1104936889
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
110676 Issued in MA
Practice address
2325 Bay State Court
Brewster, MA 02631-2141
Phone
(508) 240-7964
Fax
(508) 240-5448
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 110676 MA Primary

Addresses

Primary practice location

2325 Bay State Court
Brewster, MA 02631-2141

Mailing address

2325 Bay State Court
Brewster, MA 02631-2141
Phone (508) 240-7964

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
I20051022000123 MA Practitioner - Clinical Social Worker 4981692837 Practice locations: Brewster, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23 -25 Bay State Court
Brewster, MA 02631

23 Bay State CT
Brewster, MA 02631-2120
Phone 5082407964226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
110676MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Forrister M.D. P.C. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104936889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 BAY STATE COURT",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312141",
            "telephone_number": "508-240-7964",
            "fax_number": "508-240-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 BAY STATE COURT",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312141",
            "telephone_number": "508-240-7964",
            "fax_number": "508-240-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "THOMAS",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "MA MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "110676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, MA

Sources for this page

Verify at the official NPI Registry.