Teodolinda Wayshak Pique, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

9449 Issued in MA

Practice address

100 Merrimack St
Suite 205-F
Lowell, MA 01852-1708

Phone

(510) 332-1819

NPI assigned

Sep 22, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pique.teodolinda.mgh@direct.partners.masshiway.net

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.

• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  Medicare reassignment Care Compare group NPD
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment NPD
• General Hospital Corp

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1508390014
  NPD

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1124301429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 RIVERWALK WAY UNIT 108",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018543651",
            "telephone_number": "510-332-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MERRIMACK ST",
            "address_2": "SUITE 205-F",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521708",
            "telephone_number": "510-332-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIQUE",
        "first_name": "TEODOLINDA",
        "middle_name": "WAYSHAK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "9449",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9449",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19127",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Pinna-Perez, PHD, LICSW, LCAT
• Angie Pino Ortiz
• Lincoln N Pinsky, MD
• Emily M Pinto, LICSW
• Celestina Pipia
• Rose Pitkin
• John Clay Pitts, LPN
• Katherine Mary Pittsley, MPH, RDN, LDN
• Aaron Pivo
• Ashley A Pizarro Ortiz

• Clinical Psychologist in Lowell, MA
• Providers in Lowell, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.

Verify at the official NPI Registry.