Individual provider Active NPI

Brendan Lynch, PH.D.

  • Clinical Neuropsychologist
  • Norwood, MA
National Provider Identifier
1306043690
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
8922 Issued in MA
Practice address
89 Access Rd
Ste 24
Norwood, MA 02062-5229
Phone
(781) 551-0999
Fax
(781) 551-3396
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 8922 MA Primary
Psychologist 103T00000X 8922 MA

Addresses

Primary practice location

89 Access Rd
Ste 24
Norwood, MA 02062-5229

Mailing address

89 Access Rd
Ste 24
Norwood, MA 02062-5229
Phone (781) 551-0999

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
I20090210000164 MA Practitioner - Clinical Psychologist 3577628486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
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)

365 E St
Tewksbury Hospital
Tewksbury, MA 01876-1998
Phone (978) 851-7321

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8922MAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Apr 26, 2016 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Apr 26, 2016 Accepting new patients

Locations

365 East St
Tewksbury, MA 01876
Phone (617) 536-2186

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1306043690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 ACCESS RD",
            "address_2": "STE 24",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625229",
            "telephone_number": "781-551-0999",
            "fax_number": "781-551-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 ACCESS RD",
            "address_2": "STE 24",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625229",
            "telephone_number": "781-551-0999",
            "fax_number": "781-551-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "BRENDAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "8922",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.