Individual provider Active NPI

Nathalie Alexis, PSY.D.

  • Clinical Psychologist
  • Boston, MA
National Provider Identifier
1245886993
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
11628 Issued in MA
Practice address
133 Brookline Ave
Boston, MA 02215-3904
Phone
(805) 455-7800
NPI assigned
Aug 16, 2019
Last updated
Aug 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 11628 MA
Psychologist 103T00000X
Clinical Psychologist 103TC0700X 11628 MA Primary

Addresses

Primary practice location

133 Brookline Ave
Boston, MA 02215-3904

Mailing address

133 Brookline Ave
Boston, MA 02215-3904

Other practice location 1

165 Lenox St Unit 143
Norwood, MA 02062-3694
Phone (781) 269-2679

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211218000104 MA Practitioner - Clinical Psychologist 2264823657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11628MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Current Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1245886993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "805-455-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 Lenox St Unit 143",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MA",
            "postal_code": "020623694",
            "country_code": "US",
            "telephone_number": "781-269-2679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALEXIS",
        "first_name": "NATHALIE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "11628",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.