Individual provider Active NPI

Martin J Laroche, PHD

  • Clinical Psychologist
  • Jamaica Plain, MA
National Provider Identifier
1386653558
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7167 Issued in MA
Practice address
75 Bickford St
Jamaica Plain, MA 02130-1401
Phone
(617) 971-2201
Fax
(617) 983-1377
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7167 MA Primary

Addresses

Primary practice location

75 Bickford St
Jamaica Plain, MA 02130-1401

Mailing address

22 Chandler St
Belmont, MA 02478-5028
Phone (617) 484-6177

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
I20090813000264 MA Practitioner - Clinical Psychologist 6406900216 Reassigns benefits to 1 organization
Practice locations: Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Massachusetts Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

49 Hancock St
Suite 104
Cambridge, MA 02139-3188
Phone (617) 576-9600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7167MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pediatric Associates, Inc CurrentSince Jun 1, 2024 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

300 Longwood Ave
#B
Boston, MA 02115

75 Bickford St
Jamaica Plain, MA 02130
Phone (617) 971-2100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386653558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CHANDLER ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024785028",
            "telephone_number": "617-484-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BICKFORD ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021301401",
            "telephone_number": "617-971-2201",
            "fax_number": "617-983-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROCHE",
        "first_name": "MARTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.