Individual provider Active NPI

Jeffrey Jay Gaines, PH.D.

  • Clinical Neuropsychologist
  • Worcester, MA
National Provider Identifier
1396764692
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3141 Issued in CT
Practice address
50 Elm St
Suite 6
Worcester, MA 01609-2574
Phone
(617) 223-1563
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 8264 MA
Clinical Neuropsychologist 103G00000X 3141 CT Primary

Addresses

Primary practice location

50 Elm St
Suite 6
Worcester, MA 01609-2574

Mailing address

50 Gaylord Farm Rd
Wallingford, CT 06492-2899
Phone (203) 284-2800

Other practice location 1

50 Gaylord Farm Rd
Wallingford, CT 06492-2899
Phone (203) 284-2800

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
I20221222000776 CT Practitioner - Clinical Psychologist 7416900816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gaylord Hospital, Inc.Group PAC ID 1153224191, 39 clinicians

Practice addresses (Care Compare)

50 Gaylord Farm Rd
Wallingford, CT 06492-2828
Phone (203) 284-2800

Hospital & facility affiliations

  • Gaylord Hospital Inc Long-term care hospital, Wallingford, CT, CCN 072003

Merit-based Incentive Payment System (MIPS)

Final score
82.25 of 100Reported as group
Quality
63.07
Improvement activities
40
Cost
77.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3141CTMDPhysical Therapist
8264MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gaylord Hospital, Inc. CurrentSince Nov 1, 2022 Accepting new patients
University of Massachusetts Past Accepting new patients
Metrowest Neuropsychology, LLC Clinical Neuropsychologist Past Accepting new patients

Locations

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1396764692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 GAYLORD FARM RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922899",
            "telephone_number": "203-284-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ELM ST",
            "address_2": "SUITE 6",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092574",
            "telephone_number": "617-223-1563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Gaylord Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Wallingford",
            "state": "CT",
            "postal_code": "064922899",
            "country_code": "US",
            "telephone_number": "203-284-2800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAINES",
        "first_name": "JEFFREY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "8264",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "3141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.