Active NPI
Ilana Tal, PH.D.
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1275679771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8539
- Practice address
- 872 Mass Ave
Suite 2-5
Cambridge, MA 02139-1836 - Phone
- (617) 864-0285
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8539 | MA | Primary |
Addresses
Primary practice location
872 Mass Ave
Suite 2-5
Cambridge, MA 02139-1836
Mailing address
872 Mass Ave
Suite 2-5
Cambridge, MA 02139-1836
Phone (617) 864-0285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W06492 | Other | MA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8539 | MA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Two Brattle Center, P.C. | Past | Accepting new patients | |
| Cambridge Public Health Commission | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1487603585
-
- Psychiatry Physician
- Cambridge, MA
- NPI 1396792628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550448000000",
"number": "1275679771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "872 MASS AVE",
"address_2": "SUITE 2-5",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391836",
"telephone_number": "617-864-0285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "872 MASS AVE",
"address_2": "SUITE 2-5",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391836",
"telephone_number": "617-864-0285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAL",
"first_name": "ILANA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2019-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "8539",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "W06492",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.