Individual provider Active NPI

Elizabeth Holle Nasser, PH.D.

  • Clinical Psychologist
  • Northborough, MA
National Provider Identifier
1497788582
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8127-PR Issued in MA
Practice address
22 Fairway Dr
Northborough, MA 01532-2072
Phone
(508) 259-7684
Fax
(508) 393-1903
NPI assigned
Jul 9, 2006
Last updated
May 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2016

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 8127-PR MA Primary

Addresses

Primary practice location

22 Fairway Dr
Northborough, MA 01532-2072

Mailing address

22 Fairway Dr
Northborough, MA 01532-2072
Phone (508) 259-7684

Other identifiers 3

IdentifierTypeStateIssuer
641611OtherMATUFTS
W06270OtherMABLUE CROSS BLUE SHIELD
0502731MedicaidMA

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
I20040218000348 MA Practitioner - Clinical Psychologist 5799670824 Reassigns benefits to 1 organization
Practice locations: Northborough, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 Fairway Dr
Northborough, MA 01532-2072
Phone (508) 259-7684

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8127-PRMAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Insight Inc CurrentSince Apr 25, 2021 Accepting new patients
Pinnacle Health Management, LLP CurrentSince Mar 1, 2013 Accepting new patients
Dr. Rachel Laschever Movitz, Psy.D. Clinical Past Accepting new patients
Edgardo C. Angeles, MD & Associates, PC PastSince Apr 1, 2005 Accepting new patients
Limbic Resources Past Accepting new patients
Centers for Aging and Memory Clinical PastSince Dec 1, 2005 Accepting new patients
Dr. Gerald P. Elovitz, P.C. Past Accepting new patients

Locations

105 Webster St
Ste 8
Hanover, MA 02339
Phone (781) 312-7457

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1497788582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 FAIRWAY DR",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322072",
            "telephone_number": "508-259-7684",
            "fax_number": "508-393-1903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 FAIRWAY DR",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322072",
            "telephone_number": "508-259-7684",
            "fax_number": "508-393-1903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSER",
        "first_name": "ELIZABETH",
        "middle_name": "HOLLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8127-PR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "641611",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W06270",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0502731",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northborough, MA

Sources for this page

Verify at the official NPI Registry.