Active NPI
Martin Benowitz, EDD
- Psychologist
- Leominster, MA
National Provider Identifier
1104982024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1896
- Practice address
- 292 N Main St
Leominster, MA 01453-2207 - Phone
- (978) 534-1600
- NPI assigned
- Dec 28, 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 | 1896 | MA | Primary |
Addresses
Primary practice location
292 N Main St
Leominster, MA 01453-2207
Mailing address
292 N Main St
Leominster, MA 01453-2207
Phone (978) 534-1600
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 320818 | Other | MA | HARVARD PILGRIM HC |
| 716848 | Other | MA | TUFTS HP |
| W02045 | Other | MA | BCBS |
| 1011290 | Other | MA | BEACON HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1896 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104982024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "292 N MAIN ST",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014532207",
"telephone_number": "978-534-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "292 N MAIN ST",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014532207",
"telephone_number": "978-534-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENOWITZ",
"first_name": "MARTIN",
"credential": "EDD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "1896",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HC",
"identifier": "320818",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HP",
"identifier": "716848",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "W02045",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON HEALTH",
"identifier": "1011290",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leominster, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.