Individual provider Active NPI

Jane Elizabeth Klare, PHD

  • Clinical Psychologist
  • Belmont, MA
National Provider Identifier
1467542704
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3918 Issued in MA
Practice address
36 Stewart Terrace
Belmont, MA 02478-3956
Phone
(617) 484-7173
Fax
(617) 484-2122
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

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
Clinical Psychologist 103TC0700X 3918 MA Primary

Addresses

Primary practice location

36 Stewart Terrace
Belmont, MA 02478-3956

Mailing address

36 Stewart Terrace
Belmont, MA 02478-3956
Phone (617) 484-7173

Other identifiers 5

IdentifierTypeStateIssuer
1041160OtherFALLON
791710OtherTUFTS
W03875OtherBLUE CROSS
0500461MedicaidMA
008952OtherHARVARD PACIFICARE

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
I20101021000475 MA Practitioner - Clinical Psychologist 1850584939 Practice locations: Belmont, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

36 Stewart Ter
Belmont, MA 02478-3956
Phone (617) 484-8835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3918MAMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467542704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 STEWART TERRACE",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783956",
            "telephone_number": "617-484-7173",
            "fax_number": "617-484-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 STEWART TERRACE",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783956",
            "telephone_number": "617-484-7173",
            "fax_number": "617-484-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLARE",
        "first_name": "JANE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "3918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1041160",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "791710",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "W03875",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500461",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PACIFICARE",
            "identifier": "008952",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.