Individual provider Active NPI

Stephanie T Machell, PSY.D.

  • Clinical Psychologist
  • Belmont, MA
National Provider Identifier
1275656233
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7720 Issued in MA
Practice address
5 Watson Rd
Belmont, MA 02478-3924
Phone
(617) 776-4001
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7720 MA Primary
Clinical Child & Adolescent Psychologist 103TC2200X 7720 MA
Health Service Psychologist 103TH0100X 7720 MA
Rehabilitation Psychologist 103TR0400X 7720 MA

Addresses

Primary practice location

5 Watson Rd
Belmont, MA 02478-3924

Mailing address

30 Churchill St
Saugus, MA 01906-2535
Phone (617) 776-4001

Other identifiers 3

IdentifierTypeStateIssuer
0500224MedicaidMA
406945OtherMATUFTS HEALTH PLAN
W05932OtherMABLUE CROSS OF MA

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
I20050829000803 MA Practitioner - Clinical Psychologist 4981635992 Practice locations: Belmont, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5 Watson Rd
Suite 203
Belmont, MA 02478-3900
Phone (617) 776-4001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7720MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1275656233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CHURCHILL ST",
            "city": "SAUGUS",
            "state": "MA",
            "postal_code": "019062535",
            "telephone_number": "617-776-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 WATSON RD",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783924",
            "telephone_number": "617-776-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHELL",
        "first_name": "STEPHANIE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7720",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "7720",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "7720",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "MA",
            "license": "7720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500224",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "406945",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MA",
            "identifier": "W05932",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.