Individual provider Active NPI

Jaine L. Darwin, PSY.D.

  • Psychologist
  • Cambridge, MA
National Provider Identifier
1417980780
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2833 Issued in MA
Practice address
1619 Massachusetts Ave
#25
Cambridge, MA 02138-2734
Phone
(617) 354-7480
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
Yes

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
Psychologist 103T00000X 2833 MA Primary

Addresses

Primary practice location

1619 Massachusetts Ave
#25
Cambridge, MA 02138-2734

Mailing address

1619 Massachusetts Ave
#25
Cambridge, MA 02138-2734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • 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
I20180219000740 MA Practitioner - Clinical Psychologist 4385905108 Practice locations: Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1619 Massachusetts Ave
Apt 25
Cambridge, MA 02138-2753
Phone (617) 354-7480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2833MAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417980780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 MASSACHUSETTS AVE",
            "address_2": "#25",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021382734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 MASSACHUSETTS AVE",
            "address_2": "#25",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021382734",
            "telephone_number": "617-354-7480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARWIN",
        "first_name": "JAINE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "2833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.