Individual provider Active NPI

Richard Brostoff, MD

  • Prescribing (Medical) Psychologist
  • Lexington, MA
National Provider Identifier
1396875951
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
Practice address
10 Muzzey St
Lexington, MA 02421-5222
Phone
(781) 674-2069
NPI assigned
Mar 6, 2007
Last updated
Nov 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) Psychologist 103TP0016X NU Primary

Addresses

Primary practice location

10 Muzzey St
Lexington, MA 02421-5222

Mailing address

10 Muzzey St
Lexington, MA 02421-5222
Phone (781) 674-2069

Other identifiers 2

IdentifierTypeStateIssuer
721057OtherMATUFTS HEALTH PLAN
J04143OtherMABCBS MA

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050329000574 MA Practitioner - Psychiatry 6002862463 Practice locations: Lexington, MA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Perelman School of Med at the University of Pennsylvania, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10 Muzzey St
Lexington, MA 02421-5222
Phone (781) 674-2069

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keith P. Asarkof & Associates Past Accepting new patients

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1396875951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MUZZEY ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024215222",
            "telephone_number": "781-674-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MUZZEY ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024215222",
            "telephone_number": "781-674-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSTOFF",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "721057",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J04143",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.