Active NPI
David Lewis Tobin, PH.D.
- Psychologist
- Springfield, MA
National Provider Identifier
1104981828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6245
- Practice address
- 120 Maple St Ste 401
Springfield, MA 01103-2208 - Phone
- (413) 732-1717
- Fax
- (413) 732-5155
- NPI assigned
- Dec 22, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6245 | MA | Primary |
Addresses
Primary practice location
120 Maple St Ste 401
Springfield, MA 01103-2208
Mailing address
120 Maple St Ste 401
Springfield, MA 01103-2208
Phone (413) 732-1717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1858955 | Medicaid | MA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100722000726 | MA | Practitioner - Clinical Psychologist | 4688706898 | Practice locations: West Springfield, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10 Central St
Suite 22
West Springfield, MA 01089-2742
Phone (413) 732-1717
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6245 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104981828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 MAPLE ST STE 401",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011032208",
"telephone_number": "413-732-1717",
"fax_number": "413-732-5155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 MAPLE ST STE 401",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011032208",
"telephone_number": "413-732-1717",
"fax_number": "413-732-5155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOBIN",
"first_name": "DAVID",
"middle_name": "LEWIS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "6245",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1858955",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.