Individual provider Active NPI

Erik D. Nelson, PSY.D.

  • Clinical Psychologist
  • Worcester, MA
National Provider Identifier
1174594568
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6292 Issued in MA
Practice address
435 Shrewsbury St
Worcester, MA 01604
Phone
(508) 363-4664
Fax
(508) 752-7245
NPI assigned
Feb 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6292 MA Primary

Addresses

Primary practice location

435 Shrewsbury St
Worcester, MA 01604

Mailing address

435 Shrewsbury St
Worcester, MA 01604
Phone (508) 363-4664

Other identifiers 1

IdentifierTypeStateIssuer
0522147MedicaidMA

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
I20070815000013 MA Practitioner - Clinical Psychologist 5193816585 Reassigns benefits to 1 organization
Practice locations: Worcester, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Behavioral Healthcare ServicesGroup PAC ID 3779818828, 26 clinicians

Practice addresses (Care Compare)

435 Shrewsbury St
Worcester, MA 01604-1689
Phone 5087535554110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6292MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Healthcare Services CurrentSince Jan 22, 2020 Accepting new patients

Locations

435 Shrewsbury St
Worcester, MA 01604
Phone (508) 577-2017

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1174594568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01604",
            "telephone_number": "508-363-4664",
            "fax_number": "508-752-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01604",
            "telephone_number": "508-363-4664",
            "fax_number": "508-752-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ERIK",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0522147",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.