Individual provider Active NPI

Robert Anthony Caggiano, ED.D.

  • Psychologist
  • Newton, MA
National Provider Identifier
1255375655
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2945 Issued in MA
Practice address
165 Neshobe Rd
Newton, MA 02468-1348
Phone
(978) 354-4010
Fax
(978) 825-6101
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 2945 MA
Psychologist 103T00000X 2945 MA Primary

Addresses

Primary practice location

165 Neshobe Rd
Newton, MA 02468-1348

Mailing address

165 Neshobe Rd
Newton, MA 02468-1348
Phone (978) 354-4010

Other identifiers 2

IdentifierTypeStateIssuer
2945OtherMAMASS LIC #
0508772MedicaidMA

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
I20110204000521 MA Practitioner - Clinical Psychologist 0749460947 Reassigns benefits to 1 organization
Practice locations: Waban, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Boston University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

165 Neshobe Rd
Waban, MA 02468-1348
Phone (617) 558-1245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2945MAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Feb 13, 2013 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

Interoperability endpoints

  • Direct secure messaging: caggiano.robert.nsmc@direct.partners.masshiway.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1255375655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 NESHOBE RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024681348",
            "telephone_number": "978-354-4010",
            "fax_number": "978-825-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 NESHOBE RD",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024681348",
            "telephone_number": "978-354-4010",
            "fax_number": "978-825-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAGGIANO",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "2945",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "2945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS LIC #",
            "identifier": "2945",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0508772",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.