Individual provider Active NPI

Peter Steven Feldman, D.P.H.

  • Clinical Psychologist
  • Lexington, MA
National Provider Identifier
1508062472
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1012 Issued in MA
Practice address
35 Bedford St Ste 17
Lexington, MA 02420-4440
Phone
(781) 863-5320
Fax
(781) 863-2743
NPI assigned
Jun 26, 2007
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 1012 MA Primary

Addresses

Primary practice location

35 Bedford St Ste 17
Lexington, MA 02420-4440

Mailing address

35 Bedford St Ste 17
Lexington, MA 02420-4440
Phone (781) 863-5320

Other identifiers 1

IdentifierTypeStateIssuer
W01099OtherMABLUE CROSS BLUE SHIELD

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
I20120719000001 MA Practitioner - Clinical Psychologist 0345406344 Practice locations: Lexington, MA; Newton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

35 Bedford St
Suite 17
Lexington, MA 02420-4400
Phone (781) 863-5320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1012MAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508062472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BEDFORD ST STE 17",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204440",
            "telephone_number": "781-863-5320",
            "fax_number": "781-863-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BEDFORD ST STE 17",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204440",
            "telephone_number": "781-863-5320",
            "fax_number": "781-863-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "PETER",
        "middle_name": "STEVEN",
        "credential": "D.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "1012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W01099",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.