Active NPI
Benjamin Killilea, PH.D.
- Psychologist
- Boston, MA
National Provider Identifier
1205140746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8993
- Practice address
- 75 Fenwood Rd
Boston, MA 02115-6103 - Phone
- (617) 626-9318
- Fax
- (617) 626-9531
- NPI assigned
- Jul 26, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8993 | MA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X |
Addresses
Primary practice location
75 Fenwood Rd
Boston, MA 02115-6103
Mailing address
39 Botolph St
Quincy, MA 02171-1988
Phone (339) 987-0849
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
365 E St
Tewksbury Hospital
Tewksbury, MA 01876-1998
Phone (978) 851-7321
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8993 | MA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Commonwealth of Massachusetts | Current | Accepting new patients |
Locations
365 East St
Tewksbury, MA 01876
Phone (617) 536-2186
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.
-
- Long Term Care Hospital
- Tewksbury, MA
- NPI 1871680496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383091200000",
"number": "1205140746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 BOTOLPH ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021711988",
"telephone_number": "339-987-0849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 FENWOOD RD",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156103",
"telephone_number": "617-626-9318",
"fax_number": "617-626-9531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLILEA",
"first_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-26",
"last_updated": "2013-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "8993",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.