Charles D Cederberg, MA

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

11948 Issued in MA

Practice address

151 Merrimac St FL 5
Boston, MA 02114-4714

Phone

(617) 643-6010

NPI assigned

Jul 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

State licenses

Practice roles

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.

• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573
  NPD (past)

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1215554571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 MERRIMAC ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144714",
            "telephone_number": "617-643-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MERRIMAC ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144714",
            "telephone_number": "617-643-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEDERBERG",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-02",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "11948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine A Cecala
• Cecil R Webster Jr MD LLC
• Karen Cedant
• Jacob Cedarbaum, MD
• Bryan J. Cedeno, NONE
• Terra Cederroth
• Leslie Cedillo Verlage
• Lisa Cedrone, RN
• Philip Cefalo, M.D.
• Lisa Ceglia, M.D.

• Clinical Neuropsychologist in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Neuropsychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.