Individual provider Active NPI

Rene S Psichos, PT

  • Physical Therapist
  • Dedham, MA
National Provider Identifier
1184621617
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8123 Issued in MA
Practice address
1 Lyons St
Dedham, MA 02026-5599
Phone
(781) 329-1400
Fax
(781) 278-5664
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8123 MA Primary

Addresses

Primary practice location

1 Lyons St
Dedham, MA 02026-5599

Mailing address

PO Box 9120
Dedham, MA 02027-9120
Phone (781) 329-1400

Other identifiers 16

IdentifierTypeStateIssuer
600091OtherTUFTS COMMONWEALTH PPO
0311413OtherMASS HEALTH(DIV MED SVCS)
626254OtherHARVARD/PILGRIM
600091OtherTUFTS BENEFIT ADMIN.
626254OtherHARVARD PILGRIM PPO
P00151293OtherRAILROAD MEDICARE
Y67526OtherBS-BLUE CARE ELECT
Y67526OtherHMO BLUE/BLUE CHOICE
6400216OtherUNITED HEALTHCARE
0016757OtherNEIGHBORHOOD HEALTH PLAN
600091OtherTUFTS
626254OtherHARVARD PILGRIM POS
600091OtherTUFTS TOTAL HEALTH PLAN
626254OtherFIRST SENIORITY
Y67526OtherBLUE SHIELD-INDEMNITY
Y67526OtherBS-BLUE CARE 65

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060413000377 MA Practitioner - Physical Therapist in Private Practice 5092724344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8123MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Physical Therapist CurrentSince May 1, 2015 Accepting new patients
Atrius Health, Inc. Physical Therapist Current Accepting new patients
Atrius Health, Inc. CurrentSince May 1, 2015 Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

1 Lyons St
Dedham, MA 02026
Phone (781) 278-5511

Interoperability endpoints

  • Direct secure messaging: rpsichosdpt17418@direct.atrius.masshiway.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1184621617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9120",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020279120",
            "telephone_number": "781-329-1400",
            "fax_number": "718-278-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LYONS ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020265599",
            "telephone_number": "781-329-1400",
            "fax_number": "781-278-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSICHOS",
        "first_name": "RENE",
        "middle_name": "S",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "8123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS COMMONWEALTH PPO",
            "identifier": "600091",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH(DIV MED SVCS)",
            "identifier": "0311413",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD/PILGRIM",
            "identifier": "626254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS BENEFIT ADMIN.",
            "identifier": "600091",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PPO",
            "identifier": "626254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00151293",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS-BLUE CARE ELECT",
            "identifier": "Y67526",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE/BLUE CHOICE",
            "identifier": "Y67526",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6400216",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0016757",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "600091",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM POS",
            "identifier": "626254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS TOTAL HEALTH PLAN",
            "identifier": "600091",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SENIORITY",
            "identifier": "626254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD-INDEMNITY",
            "identifier": "Y67526",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS-BLUE CARE 65",
            "identifier": "Y67526",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.