Individual provider Active NPI

Aaron Philip Nelson, PH.D.

  • Clinical Neuropsychologist
  • Boston, MA
National Provider Identifier
1124096920
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3482 Issued in MA
Practice address
221 Longwood Ave
Brigham Behavioral Neurology Group
Boston, MA 02115-5804
Phone
(617) 732-8060
Fax
(617) 738-9122
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 3482 MA Primary
Clinical Psychologist 103TC0700X 3482 MA

Addresses

Primary practice location

221 Longwood Ave
Brigham Behavioral Neurology Group
Boston, MA 02115-5804

Mailing address

221 Longwood Ave
Brigham Behavioral Neurology Group
Boston, MA 02115-5804
Phone (617) 732-8060

Other identifiers 5

IdentifierTypeStateIssuer
0514748MedicaidMA
703415OtherMATUFTS ASSOCIATED HEALTH P
W03606OtherMABLUE CROSS BLUE SHIELD MA
001336OtherMAVALUE OPTIONS HEALTH CARE
32259OtherMAHARVARD PILGRIM HEALTH CA

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
I20110126000187 MA Practitioner - Clinical Psychologist 7618156407 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3482MAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince May 30, 2015 Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1124096920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "address_2": "BRIGHAM BEHAVIORAL NEUROLOGY GROUP",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-732-8060",
            "fax_number": "617-738-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "address_2": "BRIGHAM BEHAVIORAL NEUROLOGY GROUP",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-732-8060",
            "fax_number": "617-738-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "AARON",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "3482",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "3482",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0514748",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS ASSOCIATED HEALTH P",
            "identifier": "703415",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "W03606",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS HEALTH CARE",
            "identifier": "001336",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH CA",
            "identifier": "32259",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.