Individual provider Active NPI

Alex Jordan, PH.D.

  • Clinical Psychologist
  • Belmont, MA
National Provider Identifier
1275908063
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10189 Issued in MA
Practice address
26 Trapelo Rd
Belmont, MA 02478-4457
Phone
(617) 249-4588
NPI assigned
Dec 5, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 10189 MA Primary

Addresses

Primary practice location

26 Trapelo Rd
Belmont, MA 02478-4457

Mailing address

26 Trapelo Rd
Belmont, MA 02478-4457
Phone (617) 249-4588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 10, 2018 through Apr 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10189MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Clinical Current Accepting new patients

Locations

115 Mill St
Stop 217
Belmont, MA 02478
Phone (617) 855-3295

Interoperability endpoints

  • Direct secure messaging: jordan.alexander.mcl@direct.partners.masshiway.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1275908063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 TRAPELO RD",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024784457",
            "telephone_number": "617-249-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 TRAPELO RD",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024784457",
            "telephone_number": "617-249-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-05",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.