Individual provider Active NPI

Marshall S Fenster, PSY.D.

  • Psychologist
  • Boca Raton, FL
National Provider Identifier
1245328046
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY4991 Issued in FL
Practice address
7301 W Palmetto Park Rd
Suite 208-a
Boca Raton, FL 33433-3458
Phone
(561) 395-4422
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY4991 FL Primary
Psychologist 103T00000X 011658-1 NY

Addresses

Primary practice location

7301 W Palmetto Park Rd
Suite 208-a
Boca Raton, FL 33433-3458

Mailing address

7301 W Palmetto Park Rd
Suite 208-a
Boca Raton, FL 33433-3458
Phone (561) 395-4422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070405000153 FL Practitioner - Clinical Psychologist 8224132964 Practice locations: Boca Raton, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7301 W Palmetto Park Rd
Suite 208a
Boca Raton, FL 33433-3456
Phone (561) 395-4422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY4991FLMDPsychologist
011658-1NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245328046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 W PALMETTO PARK RD",
            "address_2": "SUITE 208-A",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333458",
            "telephone_number": "561-395-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 W PALMETTO PARK RD",
            "address_2": "SUITE 208-A",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333458",
            "telephone_number": "561-395-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSTER",
        "first_name": "MARSHALL",
        "middle_name": "S",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY4991",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "011658-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.