Individual provider Active NPI

Amy Melissa Paris, PHD

  • Clinical Psychologist
  • Boston, MA
National Provider Identifier
1255658779
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10180 Issued in MA
Practice address
75 Fenwood Rd
Boston, MA 02115
Phone
(612) 626-9654
NPI assigned
Apr 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X
Clinical Psychologist 103TC0700X 10180 MA Primary

Addresses

Primary practice location

75 Fenwood Rd
Boston, MA 02115

Mailing address

75 Fenwood Rd
Massachusetts Mental Health Center
Boston, MA 02115
Phone (612) 626-9654

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
I20150916002762 MA Practitioner - Clinical Psychologist 9032426473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

49 Hillside St
Fall River, MA 02720-5211
Phone (508) 235-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts Current Accepting new patients
The Commonwealth of Massachusetts CurrentSince Nov 29, 2022 Accepting new patients

Locations

49 Hillside St
Fall River, MA 02720
Phone (508) 235-7200

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": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1255658779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FENWOOD RD",
            "address_2": "MASSACHUSETTS MENTAL HEALTH CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "612-626-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FENWOOD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "612-626-9654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARIS",
        "first_name": "AMY",
        "middle_name": "MELISSA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.