Active NPI
Sumio Shinohara, PSY.D
- Psychologist
- Cambridge, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 8645
- Practice address
- 872 Massachusetts Ave.
Ste. 2-2, 2-7
Cambridge, MA 02139 - Phone
- (617) 395-5806
- NPI assigned
- Jan 11, 2007
- Last updated
- Mar 3, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8645 | MA | |
| Psychologist | 103T00000X | 8645 | MA | Primary |
Addresses
Primary practice location
872 Massachusetts Ave.
Ste. 2-2, 2-7
Cambridge, MA 02139
Mailing address
1000 Jefferson St.
Ste. 2C
Lynchburg, VA 24504
Phone (617) 379-0496
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1261 Furnace Brook Pkwy
Suite 31
Quincy, MA 02169-4787
Phone (617) 479-4545
851 Main St
Suite 4
Weymouth, MA 02190-1613
Phone (781) 821-2701
872 Mass Ave
Suite 2 2
Cambridge, MA 02139-3072
Phone (855) 284-7483
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8645 | MA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nova Psychiatric Services, PC | Current | Accepting new patients | |
| Patriot Behavioral Health Inc. | Current | Accepting new patients |
Locations
234 Copeland St
Ste 320
Quincy, MA 02169
Phone (617) 786-0137
1261 Furnace Brook Pkwy
Ste 22
Quincy, MA 02169
Phone (617) 302-2481
851 Main St
Ste 4
Weymouth, MA 02190
Phone (781) 340-1222
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Prime Behavioral Health
- Community/Behavioral Health Agency
- Quincy, MA
- NPI 1881782522
-
- Cognitive & Behavioral Psychologist
- Quincy, MA
- NPI 1518085968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425340800000",
"number": "1457401564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 JEFFERSON ST.",
"address_2": "STE. 2C",
"city": "LYNCHBURG",
"state": "VA",
"postal_code": "24504",
"telephone_number": "617-379-0496",
"fax_number": "617-807-0958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "872 MASSACHUSETTS AVE.",
"address_2": "STE. 2-2, 2-7",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "02139",
"telephone_number": "617-395-5806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHINOHARA",
"first_name": "SUMIO",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2015-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "8645",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "8645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.