Individual provider Active NPI

Brian Charles Castelluccio, PH.D.

  • Clinical Psychologist
  • North Easton, MA
National Provider Identifier
1508485301
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY5000514 Issued in MA
Practice address
115 Main St Ste 2D
North Easton, MA 02356-1469
Phone
(781) 551-0999
NPI assigned
Apr 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS01827 RI
Clinical Psychologist 103TC0700X PSY5000514 MA Primary

Addresses

Primary practice location

115 Main St Ste 2D
North Easton, MA 02356-1469

Mailing address

115 Main St Ste 2D
North Easton, MA 02356-1469

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
I20230526000812 MA Practitioner - Clinical Psychologist 7214368851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Connecticut School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

115 Main St
Suite D
North Easton, MA 02356-1468
Phone (508) 238-7766

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY5000514MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Clinical Neuropsychologist CurrentSince May 12, 2023 Accepting new patients

Locations

115 Main St
Ste D
North Easton, MA 02356
Phone (508) 238-7766

115 Main St
Ste 2D
North Easton, MA 02356
Phone (508) 238-7766

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

Organizations & group practices 1

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": "1586563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1508485301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MAIN ST STE 2D",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MAIN ST STE 2D",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561469",
            "telephone_number": "781-551-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLUCCIO",
        "first_name": "BRIAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-11",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "RI",
            "license": "PS01827",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY5000514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Easton, MA

Sources for this page

Verify at the official NPI Registry.