Individual provider Active NPI

Ebi Okara, ED.D.

  • Clinical Psychologist
  • Randolph, MA
National Provider Identifier
1467686915
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6907 Issued in MA
Practice address
490 N Main St
Suite 2
Randolph, MA 02368-3741
Phone
(781) 963-1200
Fax
(781) 963-1201
NPI assigned
May 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2009

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 6907 MA Primary

Addresses

Primary practice location

490 N Main St
Suite 2
Randolph, MA 02368-3741

Mailing address

490 N Main St
Suite 2
Randolph, MA 02368-3741
Phone (781) 963-1200

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
I20050126000536 MA Practitioner - Clinical Psychologist 0042260192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metis Psychological AssociatesGroup PAC ID 9335295682, 3 clinicians

Practice addresses (Care Compare)

420 Main St
Suite 21
Walpole, MA 02081-3753
Phone (781) 963-1200

490 N Main St
Suite 2
Randolph, MA 02368-3741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6907MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Metis Psychological Associates CurrentSince Apr 6, 2009 Accepting new patients

Locations

490 N Main St
Ste 2
Randolph, MA 02368
Phone (781) 963-1200

420 Main St
Ste 21
Walpole, MA 02081
Phone (781) 963-1200

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Beth Israel Deaconess Hospital-Milton IncMilton, MA, CCN 220108 Hospital Corporate Director Oct 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1467686915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 N MAIN ST",
            "address_2": "SUITE 2",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023683741",
            "telephone_number": "781-963-1200",
            "fax_number": "781-963-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 N MAIN ST",
            "address_2": "SUITE 2",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023683741",
            "telephone_number": "781-963-1200",
            "fax_number": "781-963-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKARA",
        "first_name": "EBI",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "6907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, MA

Sources for this page

Verify at the official NPI Registry.