Individual provider Active NPI

Roger R Davies, SCD.

  • Clinical Psychologist
  • Melrose, MA
National Provider Identifier
1194785865
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3306 Issued in MA
Practice address
1 W Foster St
Suite 10
Melrose, MA 02176-3810
Phone
(617) 306-9095
Fax
(339) 293-4299
NPI assigned
Mar 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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 3306 MA Primary

Addresses

Primary practice location

1 W Foster St
Suite 10
Melrose, MA 02176-3810

Mailing address

1 W Foster St
Suite 10
Melrose, MA 02176-3810
Phone (781) 306-9095

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
I20090811000601 MA Practitioner - Clinical Psychologist 6204980188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 W Foster St
Suite 4
Melrose, MA 02176-3879
Phone (617) 306-9095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Grandview Psychological Services, LLC Clinical CurrentSince Feb 9, 2011 Accepting new patients
Child and Family Psychological Services, PLLC Clinical PastSince Sep 19, 2018 Accepting new patients
Psychological Care Associates, P.C. Clinical PastSince Sep 6, 1993 Accepting new patients

Locations

1 W Foster St
Ste 4
Melrose, MA 02176
Phone (617) 306-9095

1 W Foster St
Ste 10
Melrose, MA 02176
Phone (617) 306-9095

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": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1194785865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W FOSTER ST",
            "address_2": "SUITE 10",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763810",
            "telephone_number": "781-306-9095",
            "fax_number": "339-293-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W FOSTER ST",
            "address_2": "SUITE 10",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763810",
            "telephone_number": "617-306-9095",
            "fax_number": "339-293-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "ROGER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "SCD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "3306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.