Individual provider Active NPI

Eugene Joseph Fierman, M.D.

  • Psychiatry Physician
  • Brookline, MA
National Provider Identifier
1366429839
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35300 Issued in MA
Practice address
169 Clark Rd
Brookline, MA 02445-5846
Phone
(617) 983-0174
Fax
(617) 232-2067
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35300 MA Primary

Addresses

Primary practice location

169 Clark Rd
Brookline, MA 02445-5846

Mailing address

169 Clark Rd
Brookline, MA 02445-5846
Phone (617) 731-9678

Other identifiers 1

IdentifierTypeStateIssuer
3018253MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35300MAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1366429839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 CLARK RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024455846",
            "telephone_number": "617-731-9678",
            "fax_number": "617-232-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 CLARK RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024455846",
            "telephone_number": "617-983-0174",
            "fax_number": "617-232-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIERMAN",
        "first_name": "EUGENE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "35300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3018253",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; 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.