Active NPI
Carolyn Anne Rieder, PH.D.
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1124074224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4409
- Practice address
- 106 Winthrop St
Cambridge, MA 02138-4930 - Phone
- (617) 855-3642
- Fax
- (617) 491-3970
- NPI assigned
- May 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4409 | MA | Primary |
Addresses
Primary practice location
106 Winthrop St
Cambridge, MA 02138-4930
Mailing address
106 Winthrop St
Cambridge, MA 02138-4930
Phone (617) 855-3642
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W04241 | Other | MA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2015 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4409 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372636800000",
"number": "1124074224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 WINTHROP ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384930",
"telephone_number": "617-855-3642",
"fax_number": "617-491-3970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 WINTHROP ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384930",
"telephone_number": "617-855-3642",
"fax_number": "617-491-3970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIEDER",
"first_name": "CAROLYN",
"middle_name": "ANNE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2013-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "4409",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "W04241",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.