Emma Lorraine Weizenbaum, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

11981 Issued in MA

Practice address

60 Fenwood Rd
Boston, MA 02115-6128

Phone

(617) 525-9108

NPI assigned

May 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brigham and Women's Hospital Hospital, Boston, MA, CCN 220110

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: weizenbaum.emma.bwh@direct.partners.masshiway.net

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Brigham and Women's Hospital

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1093885816
  NPD

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

• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation

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

{
    "created_epoch": "1590192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1225651375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 IRVING ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722705",
            "telephone_number": "512-217-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FENWOOD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156128",
            "telephone_number": "617-525-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIZENBAUM",
        "first_name": "EMMA",
        "middle_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-23",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11981",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "11981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura T Weissman, M.D.
• Alan B Weitberg, M.D.
• Merrill Weitzel, MD
• James I Weitzman, M.D.
• Tammy Sophia Weitzman, LICSW
• Brigid M. Welber, RN, CRNA
• Joshua Welborne, DDS
• Claire Jeanne Welch, LICSW
• Finnian Charles Welch
• John Crawford Welch, CRNA

• 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 Mar 19, 2024; 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.

Verify at the official NPI Registry.