Active NPI
Alex Jordan, PH.D.
- Clinical Psychologist
- Belmont, MA
National Provider Identifier
1275908063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10189
- 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
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 | 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
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 10189 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New 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
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.