Individual provider Active NPI

Paul R. Solomon, PH.D.

  • Clinical Neuropsychologist
  • Newton, MA
National Provider Identifier
1417029802
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
743 Issued in VT
Practice address
180 Wells Avenue
Suite 304
Newton, MA 02459
Phone
(802) 447-1409
Fax
(802) 442-5199
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 743 VT Primary

Addresses

Primary practice location

180 Wells Avenue
Suite 304
Newton, MA 02459

Mailing address

180 Wells Avenue
Suite 304
Newton, MA 02459
Phone (617) 699-6927

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
I20121109000004 MA Practitioner - Clinical Psychologist 6901856376 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
743VTMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Center for Memory, Inc CurrentSince Jun 15, 2021 Accepting new patients
Memory Clinic, Inc. Clinical Neuropsychologist PastSince Mar 2, 2020 Accepting new patients
Clinical Neuroscience Research Associates, Inc. PastSince Jun 22, 2010 Accepting new patients

Locations

180 Wells Ave
Ste 304
Newton Center, MA 02459
Phone (617) 699-6927

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1417029802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 WELLS AVENUE",
            "address_2": "SUITE 304",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02459",
            "telephone_number": "617-699-6927",
            "fax_number": "617-383-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WELLS AVENUE",
            "address_2": "SUITE 304",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02459",
            "telephone_number": "802-447-1409",
            "fax_number": "802-442-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "PAUL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VT",
            "license": "743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.