Individual provider Active NPI

Nancy Santoro, PSYD

  • Clinical Psychologist
  • Lexington, MA
National Provider Identifier
1194852517
Registry record updated Jan 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8673 Issued in MA
Practice address
4 Militia Drive
Suite 23
Lexington, MA 02421-4737
Phone
(978) 831-7701
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2015

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 8673 MA Primary

Addresses

Primary practice location

4 Militia Drive
Suite 23
Lexington, MA 02421-4737

Mailing address

4 Militia Drive
Suite 23
Lexington, MA 02421-4737
Phone (978) 831-7701

Other identifiers 1

IdentifierTypeStateIssuer
W10556OtherMABCBS

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
I20110819000448 MA Practitioner - Clinical Psychologist 1456521913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eliot Community Human ServicesGroup PAC ID 2062488000, 82 clinicians

Practice addresses (Care Compare)

86 Baker Ave Ext
Suite 100
Concord, MA 01742-2132
Phone (978) 369-1113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8673MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Community Human Services Clinical CurrentSince Jun 13, 2011 Accepting new patients
Eliot Community Human Services CurrentSince Jun 13, 2011 Accepting new patients
Thriving Together Counseling and Wellness LLC Clinical CurrentSince Jul 17, 2022 Accepting new patients

Locations

86 Baker Avenue Ext
Ste 100
Concord, MA 01742
Phone (978) 202-4156

125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060

4 Militia Dr
Ste 23
Lexington, MA 02421
Phone (617) 513-1775

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420675200000",
    "number": "1194852517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MILITIA DRIVE",
            "address_2": "SUITE 23",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214737",
            "telephone_number": "978-831-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MILITIA DRIVE",
            "address_2": "SUITE 23",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214737",
            "telephone_number": "978-831-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTORO",
        "first_name": "NANCY",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W10556",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.