Active NPI
Dan J Siskind, MD BS MPH
- Psychiatry Physician
- Jamaica Plain, MA
National Provider Identifier
1164469946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 223353
- Practice address
- 3313 Washington St
Suite 1 Pact
Jamaica Plain, MA 02130 - Phone
- (617) 971-9400
- Fax
- (617) 971-9670
- NPI assigned
- Jun 1, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 223353 | MA | Primary |
Addresses
Primary practice location
3313 Washington St
Suite 1 Pact
Jamaica Plain, MA 02130
Mailing address
3313 Washington St
Suite 1 Pact
Jamaica Plain, MA 02130
Phone (617) 971-9400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MS0586276A | Other | MA CONTROLLED SUBSTANCE | |
| 2115174 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Science, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 223353 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Psychiatric Planners, Inc | Past | Accepting new patients | |
| Bournewood Clinical Associates | Psychiatry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Bournewood Hospital
- Psychiatric Hospital
- Brookline, MA
- NPI 1093714412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1164469946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3313 WASHINGTON ST",
"address_2": "SUITE 1 PACT",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "02130",
"telephone_number": "617-971-9400",
"fax_number": "617-971-9670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3313 WASHINGTON ST",
"address_2": "SUITE 1 PACT",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "02130",
"telephone_number": "617-971-9400",
"fax_number": "617-971-9670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISKIND",
"first_name": "DAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD BS MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "223353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA CONTROLLED SUBSTANCE",
"identifier": "MS0586276A",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2115174",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.