Individual provider Active NPI

Leo F Polizoti, PH.D.

  • Psychologist
  • Worcester, MA
National Provider Identifier
1356452528
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2155 Issued in MA
Practice address
338 Highland St
Worcester, MA 01602-2143
Phone
(508) 798-2399
Fax
(508) 798-2399
NPI assigned
Aug 31, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2155 MA Primary

Addresses

Primary practice location

338 Highland St
Worcester, MA 01602-2143

Mailing address

338 Highland St
Worcester, MA 01602-2143
Phone (508) 798-2399

Other identifiers 1

IdentifierTypeStateIssuer
0506141MedicaidMA

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
I20110328000531 MA Practitioner - Clinical Psychologist 2567645666 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Decision Institute, Inc. CurrentSince Apr 3, 2013 Accepting new patients

Locations

255 Park Ave
Ste 1000
Worcester, MA 01609
Phone (508) 446-4114

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, 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1356452528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 HIGHLAND ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022143",
            "telephone_number": "508-798-2399",
            "fax_number": "508-798-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 HIGHLAND ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016022143",
            "telephone_number": "508-798-2399",
            "fax_number": "508-798-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLIZOTI",
        "first_name": "LEO",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "2155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0506141",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.