Jeremy Mirsky, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

9362 Issued in MA

Practice address

5 Neponset St
Worcester, MA 01606-2714

Phone

(508) 856-0732

Fax

(508) 425-5126

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mirsky.jeremy.puc@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.

• Mass General Brigham Community Physicians Inc.

  • Internal Medicine Physician
  • Haverhill, MA
  • NPI 1891112637
  Medicare reassignment Care Compare group NPD
• Mass General Brigham Community Physicians Inc

  • Cardiovascular Disease Physician
  • Medford, MA
  • NPI 1548638265
  NPD
• Mass General Brigham Urgent Care LLC

  • Urgent Care Clinic/Center
  • Cambridge, MA
  • NPI 1881141398
  NPD
• Reliant Medical Group, Inc

  • Physical Therapist
  • Worcester, MA
  • NPI 1295827962
  NPD (past)
• Gaylord Hospital, Inc.

  dba Gaylord Hospital

  • Long Term Care Hospital
  • Wallingford, CT
  • NPI 1730137753
  NPD (past)
• The Hospital of Central Connecticut at New Britain General and Bradley

  dba The Hospital of Central Connecticut

  • General Acute Care Hospital
  • New Britain, CT
  • NPI 1053477075
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1245274885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL STREET12",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-856-0732",
            "fax_number": "508-425-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-856-0732",
            "fax_number": "508-425-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRSKY",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CT",
            "license": "002580",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "9362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josue Miranda Quiles Sr., LICSW
• Edwin Miranda Jr.
• Kayla Miranda
• Edmond Mireku
• Sara Mirick
• Kimberly A Mirsky, MS RD LDN
• Susan M Mirsky
• Anne M Mirth, M.D.
• Julian Ngendo Miru, PMHNP
• Kevin Mishan, DO

• Psychologist in Worcester, MA
• Providers in Worcester, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.