Individual provider Active NPI

Maria Masotta, PSY.D.

  • Psychologist
  • Old Saybrook, CT
National Provider Identifier
1346396660
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8411 Issued in MA
Practice address
20 Research Pkwy
Old Saybrook, CT 06475-4214
Phone
(800) 370-3651
NPI assigned
Jan 27, 2007
Last updated
Feb 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8411 MA Primary

Addresses

Primary practice location

20 Research Pkwy
Old Saybrook, CT 06475-4214

Mailing address

20 Research Pkwy
Old Saybrook, CT 06475-4214
Phone (800) 370-3651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200323000854 CT Practitioner - Clinical Psychologist 7113178294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Mental Health Specialists IncGroup PAC ID 0345130563, 65 clinicians
Value Based Long Term Care K PCGroup PAC ID 1355881418, 61 clinicians

Practice addresses (Care Compare)

270 Farmington Ave
Suite 309
Farmington, CT 06032-1953
Phone (860) 677-5570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8411MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medoptions of Massachusetts LLC PastSince Oct 1, 1994 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1346396660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PKWY",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754214",
            "telephone_number": "800-370-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PKWY",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754214",
            "telephone_number": "800-370-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASOTTA",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

Verify at the official NPI Registry.