Active NPI
Allison Nussbaum, D.O.
- Child & Adolescent Psychiatry Physician
- Cambridge, MA
National Provider Identifier
1316309545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 288074
- Practice address
- 1493 Cambridge St
Cambridge, MA 02139-1099 - Phone
- (203) 737-7129
- NPI assigned
- Mar 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 62354 | CT | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 288074 | MA | Primary |
Addresses
Primary practice location
1493 Cambridge St
Cambridge, MA 02139-1099
Mailing address
1493 Cambridge St
Cambridge, MA 02139-1099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 299074 | Other | MA | MEDICAL LICENSE |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62354 | CT | MD | Psychiatry Physician |
| 288074 | MA | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cambridge Public Health Commission | Current | Accepting new patients | |
| Cambridge Public Health Commission | Current | Accepting new patients | |
| Newton Wellesley Hospital | Current | Accepting new patients | |
| Cambridge Public Health Commission | Current | Accepting new patients | |
| Mass General Brigham Medical Group Suburban Massachusetts Inc | Child & Adolescent Psychiatry | Current | Accepting new patients |
Locations
1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185
350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583
2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000
Interoperability endpoints
- nussbaum.allison.nwh@direct.partners.masshiway.net
Organizations & group practices 5
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
-
- Family Medicine Physician
- Newton, MA
- NPI 1538191218
Child & Adolescent Psychiatry
-
- Clinic/Center
- Cambridge, MA
- NPI 1306908405
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1932313228
-
- General Acute Care Hospital
- Newton, MA
- NPI 1952845521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1316309545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1493 CAMBRIDGE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1493 CAMBRIDGE ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021391099",
"telephone_number": "203-737-7129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUSSBAUM",
"first_name": "ALLISON",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-26",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "62354",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "288074",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "299074",
"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 Sep 13, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.