Active NPI
Edward Bruce Bynum, PH.D.
- Psychologist
- Amherst, MA
National Provider Identifier
1497833750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2404
- Practice address
- 111 Infirmary Way
127 Hills North
Amherst, MA 01003-9287 - Phone
- (413) 545-2337
- Fax
- (413) 577-5117
- NPI assigned
- Nov 2, 2006
- 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 | 2404 | MA | Primary |
Addresses
Primary practice location
111 Infirmary Way
127 Hills North
Amherst, MA 01003-9287
Mailing address
111 Infirmary Way
127 Hills North
Amherst, MA 01003-9287
Phone (413) 545-2337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 25012 | Other | HEALTH NEW ENGLAND |
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 |
|---|---|---|---|---|
| I20201106000301 | MA | Practitioner - Clinical Psychologist | 3971881970 | Practice locations: Hadley, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
195 Russell St
Suite B8
Hadley, MA 01035-9552
Phone (413) 801-1117
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2404 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497833750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 INFIRMARY WAY",
"address_2": "127 HILLS NORTH",
"city": "AMHERST",
"state": "MA",
"postal_code": "010039287",
"telephone_number": "413-545-2337",
"fax_number": "413-577-5117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 INFIRMARY WAY",
"address_2": "127 HILLS NORTH",
"city": "AMHERST",
"state": "MA",
"postal_code": "010039287",
"telephone_number": "413-545-2337",
"fax_number": "413-577-5117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYNUM",
"first_name": "EDWARD",
"middle_name": "BRUCE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "2404",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "25012",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Amherst, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.