Individual provider Active NPI

Amber N Edinoff, MD

  • Addiction Psychiatry Physician
  • Belmont, MA
National Provider Identifier
1144545344
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
License
290911 Issued in MA
Practice address
115 Mill St
Belmont, MA 02478-1048
Phone
(617) 855-3803
NPI assigned
Mar 30, 2010
Last updated
Nov 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X R76606 AZ
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X 290911 MA
Addiction Psychiatry Physician 2084P0802X 290911 MA Primary

Addresses

Primary practice location

115 Mill St
Belmont, MA 02478-1048

Mailing address

115 Mill St
Belmont, MA 02478-1048
Phone (617) 855-3802

Other practice location 1

2601 E. Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-5011

Other names 1

  • Ms. Amber N Gardner Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230530000788 MA Practitioner - Psychiatry 8022347319 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.3 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
290911MAMDAddiction Psychiatry Physician
R76606AZMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation CurrentSince Jul 1, 2023 Accepting new patients
Physicians of Cape Cod Hospital CurrentSince Nov 22, 2023 Accepting new patients
Physicians of Falmouth Hospital CurrentSince Nov 22, 2023 Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

100 Ter Heun Dr
Falmouth, MA 02540
Phone (508) 457-3501

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1144545344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781048",
            "telephone_number": "617-855-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781048",
            "telephone_number": "617-855-3803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 E. Roosevelt St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "85008",
            "country_code": "US",
            "telephone_number": "602-344-5011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDINOFF",
        "first_name": "AMBER",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-30",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "R76606",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "290911",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MA",
            "license": "290911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "GARDNER",
            "middle_name": "N",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.