Individual provider Active NPI

Matthew Scott Robinson, PH.D.

  • Clinical Psychologist
  • Boston, MA
National Provider Identifier
1497889372
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7658 Issued in MA
Practice address
20 Vining St
Boston, MA 02115-6115
Phone
(617) 626-9780
Fax
(617) 626-9510
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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 7658 MA Primary

Addresses

Primary practice location

20 Vining St
Boston, MA 02115-6115

Mailing address

116 Dyer Ave
Milton, MA 02186-1514
Phone (617) 626-9780

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
I20110810000014 MA Practitioner - Clinical Psychologist 1557530409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

75 Fenwood Rd
Boston, MA 02115-6103
Phone (617) 626-9300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7658MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Jun 1, 2011 Accepting new patients
The Commonwealth of Massachusetts Current Accepting new patients
The Commonwealth of Massachusetts CurrentSince Jun 1, 2011 Accepting new patients

Locations

20 Vining St
Boston, MA 02115
Phone (617) 626-9300

75 Fenwood Rd
Boston, MA 02115
Phone (617) 626-9300

85 Newton St
Boston, MA 02118
Phone (617) 305-9960

20 Vining St
Rm 114
Boston, MA 02115

76 Amory St
Roxbury, MA 02119
Phone (617) 626-9300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1497889372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 DYER AVE",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021861514",
            "telephone_number": "617-626-9780",
            "fax_number": "617-626-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 VINING ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156115",
            "telephone_number": "617-626-9780",
            "fax_number": "617-626-9510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "MATTHEW",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.