Active NPI
Brian Marcus Osullivan, PHD
- Psychologist
- Northborough, MA
National Provider Identifier
1467419168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3157
- Practice address
- 2 Whitney St
Northborough, MA 01532-1845 - Phone
- (508) 831-3030
- NPI assigned
- Apr 27, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3157 | MA | Primary |
Addresses
Primary practice location
2 Whitney St
Northborough, MA 01532-1845
Mailing address
2 Whitney St
Northborough, MA 01532-1845
Phone (508) 450-3071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3157 | MA | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jonathan Rothman, M.D. | 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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527552000000",
"number": "1467419168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WHITNEY ST",
"city": "NORTHBOROUGH",
"state": "MA",
"postal_code": "015321845",
"telephone_number": "508-450-3071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 WHITNEY ST",
"city": "NORTHBOROUGH",
"state": "MA",
"postal_code": "015321845",
"telephone_number": "508-831-3030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSULLIVAN",
"first_name": "BRIAN",
"middle_name": "MARCUS",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2018-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "3157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.