John Michael Madonna Jr., EDD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2711 Issued in MA

Practice address

469 Chandler Street
Worcester, MA 01602

Phone

(508) 757-7430

Fax

(508) 791-5845

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Clearview Ocd Counseling, LLC

  • Mental Health Counselor
  • Worcester, MA
  • NPI 1417430851
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467508259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 CHANDLER STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01602",
            "telephone_number": "508-757-7430",
            "fax_number": "508-791-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 CHANDLER STREET",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01602",
            "telephone_number": "508-757-7430",
            "fax_number": "508-791-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADONNA",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W02886",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rashad Madi, MD
• Meredith Madigan, OTR/L
• Shashidhar Reddy Madireddy, M.D
• John Mark Madison, M.D.
• Lawrence Charles Madoff, MD
• John C. Madore, M.D.
• Emmanuel C Maduakor, M.D.
• May N Maduakor
• Brian Mady, M.D.
• Christin Maesto

• Clinical Psychologist in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.