Active NPI
Eleanor B. Paradise, PH.D.
- Clinical Psychologist
- Newton Centre, MA
National Provider Identifier
1154472652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1207
- Practice address
- 10 Langley Rd
Suite 401
Newton Centre, MA 02459-1972 - Phone
- (617) 969-7876
- Fax
- (617) 558-1206
- NPI assigned
- Jan 13, 2007
- 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 | 1207 | MA | Primary |
Addresses
Primary practice location
10 Langley Rd
Suite 401
Newton Centre, MA 02459-1972
Mailing address
30 Gammons Rd
Waban, MA 02468-1216
Phone (617) 332-3112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W02743 | Other | MA | BLUECROSSBLUESHIELD OF MA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110119000969 | MA | Practitioner - Clinical Psychologist | 9830378199 | Practice locations: Newton Center, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
10 Langley Rd
Newton, MA 02459-1917
Phone (617) 969-7876
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1207 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154472652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 GAMMONS RD",
"city": "WABAN",
"state": "MA",
"postal_code": "024681216",
"telephone_number": "617-332-3112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 LANGLEY RD",
"address_2": "SUITE 401",
"city": "NEWTON CENTRE",
"state": "MA",
"postal_code": "024591972",
"telephone_number": "617-969-7876",
"fax_number": "617-558-1206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARADISE",
"first_name": "ELEANOR",
"middle_name": "B.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "1207",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELD OF MA",
"identifier": "W02743",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton Centre, 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.
- 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.