Active NPI
Mark Aaron Gapen, PH.D.
- Psychologist
- Brookline, MA
National Provider Identifier
1467786616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 1269 Beacon St
Brookline, MA 02446-5248 - Phone
- (617) 232-1303
- NPI assigned
- Sep 21, 2009
- Sex
- Male
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
1269 Beacon St
Brookline, MA 02446-5248
Mailing address
40 Long Ave
Boston, MA 02134-2554
Phone (617) 202-5150
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160222002313 | MA | Practitioner - Clinical Psychologist | 7719146943 | Practice locations: Hadley, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Emory University School of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
104 Russell St
Hadley, MA 01035-9570
104 Russell St
Suite 6
Hadley, MA 01035-9581
Phone (413) 351-0562
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9417 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253491200000",
"number": "1467786616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 LONG AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021342554",
"telephone_number": "617-202-5150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1269 BEACON ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465248",
"telephone_number": "617-232-1303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAPEN",
"first_name": "MARK",
"middle_name": "AARON",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-21",
"last_updated": "2009-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.