Michael Rundlett, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4877 Issued in MA

Practice address

169 Libbey Industrial Pkwy
2ND Floor
Weymouth, MA 02189-3101

Phone

(781) 682-1060

Fax

(781) 682-1061

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Neurobehavioral Associates III, Inc

  • Geriatric Psychiatry Physician
  • Weymouth, MA
  • NPI 1205926946

  Clinical

  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1306936505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 LIBBEY INDUSTRIAL PKWY",
            "address_2": "2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893101",
            "telephone_number": "781-682-1060",
            "fax_number": "781-682-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 LIBBEY INDUSTRIAL PKWY",
            "address_2": "2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893101",
            "telephone_number": "781-682-1060",
            "fax_number": "781-682-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDLETT",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4877",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "4877",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER NUMBER",
            "identifier": "110251000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "W04645",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER NU",
            "identifier": "020923",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE PROVIDER NUMBER",
            "identifier": "6192642",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Rosania
• Jamie Kazlauskas Rosebrock, CRNA
• Maureen E Rosenplanter, LICSW
• Shannon Kathleen Roy, M.A., NCC, LMHC
• Simon P Roy, M.D.
• Elizabeth Bunting Russ, DMD
• Diane S Rutan, NP
• Patrick Ryan
• Phoebe K Ryan
• Hasti Sabbaghan, DMD

• Clinical Psychologist in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.