Individual provider Active NPI

John Paul Holleran, ED.D.

  • Clinical Psychologist
  • Hingham, MA
National Provider Identifier
1467501213
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 3148 Issued in MA
Practice address
62 Derby St
Suite 15
Hingham, MA 02043-3728
Phone
(781) 740-8213
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 3148 MA Primary

Addresses

Primary practice location

62 Derby St
Suite 15
Hingham, MA 02043-3728

Mailing address

2 Woodbridge Rd
Hingham, MA 02043-3144
Phone (781) 749-4580

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
I20070719000272 MA Practitioner - Clinical Psychologist 4981705084 Practice locations: Hingham, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

62 Derby St
Hingham, MA 02043-3718
Phone (781) 740-8213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 3148MAMDClinical Psychologist
3148MAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467501213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WOODBRIDGE RD",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020433144",
            "telephone_number": "781-749-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 DERBY ST",
            "address_2": "SUITE 15",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "020433728",
            "telephone_number": "781-740-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLERAN",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PY 3148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hingham, MA

Sources for this page

Verify at the official NPI Registry.