Individual provider Active NPI

Bruce Swartz, PSY.D.

  • Clinical Psychologist
  • West Newton, MA
National Provider Identifier
1477618742
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4345 Issued in MA
Practice address
1121 Washington St
Suite #4
West Newton, MA 02465-2149
Phone
(617) 971-3007
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
Yes

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 4345 MA Primary

Addresses

Primary practice location

1121 Washington St
Suite #4
West Newton, MA 02465-2149

Mailing address

124 Garland Rd
Newton Centre, MA 02459-1710

Other identifiers 3

IdentifierTypeStateIssuer
000000033045OtherMABMC HEALTHNET
0522694MedicaidMA
550010007758OtherMAHARVARD PILGRIM

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
I20081002000162 MA Practitioner - Clinical Psychologist 9335217421 Practice locations: Newton Highlands, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1172 Beacon St
Suite 401
Newton, MA 02461-1149
Phone (617) 527-1981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4345MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477618742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GARLAND RD",
            "city": "NEWTON CENTRE",
            "state": "MA",
            "postal_code": "024591710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 WASHINGTON ST",
            "address_2": "SUITE #4",
            "city": "WEST NEWTON",
            "state": "MA",
            "postal_code": "024652149",
            "telephone_number": "617-971-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWARTZ",
        "first_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "000000033045",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0522694",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "550010007758",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Newton, MA

Sources for this page

Verify at the official NPI Registry.