Albert Wallace Deckel, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

8183 Issued in MA

Practice address

382 W Main St
Suite 202
Northborough, MA 01532-2157

Phone

(508) 393-3820

Fax

(505) 393-3814

NPI assigned

Jul 13, 2005

Last updated

Aug 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Albert W Deckel Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Neuropsychology Services, PC

  • Adult Mental Health Clinic/Center
  • Northborough, MA
  • NPI 1205137056
  NPD (past) Authorized official
• Middlesex Internal Medicine Associates, Inc.

  • Cardiovascular Disease Physician
  • Marlborough, MA
  • NPI 1265601033
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1487652483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 605",
            "city": "NORTH GRAFTON",
            "state": "MA",
            "postal_code": "015360605",
            "telephone_number": "508-393-3820",
            "fax_number": "508-393-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W MAIN ST",
            "address_2": "SUITE 202",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322157",
            "telephone_number": "508-393-3820",
            "fax_number": "505-393-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKEL",
        "first_name": "ALBERT",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "8183",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "8183",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8183",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0522791",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALBERT",
            "last_name": "DECKEL",
            "middle_name": "W",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amanda Theresa Dafoe, LICSW
• David S Wald DMD
• Shannon J Davidenko, LMHC
• Alicia Wells Day, BCBA, LABA
• Cynthia De Sousa, RN
• Islam Mohammad Dehis, DMD
• Olivia Marie Demers, DPT
• Dental Solutions of Northboro
• Ummesalma Dhariwala
• Diamond Livery, LLC

• Clinical Neuropsychologist in Northborough, MA
• Providers in Northborough, MA by specialty
• Clinical Neuropsychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.