Individual provider Active NPI

Amy Jean Clara, PSY.D.

  • Clinical Psychologist
  • Foxboro, MA
National Provider Identifier
1194123240
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10863 Issued in MA
Practice address
30 Mechanic St
Foxboro, MA 02035
Phone
(508) 542-2133
Fax
(774) 215-5541
NPI assigned
Dec 5, 2014
Last updated
Jan 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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 10863 MA Primary

Addresses

Primary practice location

30 Mechanic St
Foxboro, MA 02035

Mailing address

30 Mechanic St
Foxboro, MA 02035-4021
Phone (508) 542-2133

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
I20180830002080 MA Practitioner - Clinical Psychologist 2062762719 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10863MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kerzner Associates PC Clinical CurrentSince Jul 31, 2018 Accepting new patients
The General Hospital Corporation CurrentSince May 14, 2020 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince May 14, 2020 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

30 Mechanic St
Foxborough, MA 02035
Phone (508) 543-2133

Interoperability endpoints

  • Direct secure messaging: clara.amy.mgh@direct.partners.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1194123240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MECHANIC ST",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "020354021",
            "telephone_number": "508-542-2133",
            "fax_number": "774-215-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MECHANIC ST",
            "city": "FOXBORO",
            "state": "MA",
            "postal_code": "02035",
            "telephone_number": "508-542-2133",
            "fax_number": "774-215-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARA",
        "first_name": "AMY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foxboro, MA

Sources for this page

Verify at the official NPI Registry.