Individual provider Active NPI

Elyssa Briann Weber Ku

  • Psychologist
  • Norwood, MA
National Provider Identifier
1528404332
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
11387 Issued in MA
Practice address
89 Access Rd Ste 24
Norwood, MA 02062-5233
Phone
(815) 551-0999
NPI assigned
May 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 11387 MA Primary

Addresses

Primary practice location

89 Access Rd Ste 24
Norwood, MA 02062-5233

Mailing address

89 Access Rd Ste 24
Norwood, MA 02062-5233
Phone (781) 551-0999

Other practice location 1

1493 Cambridge St
Cambridge Health Alliance
Cambridge, MA 02139-1047
Phone (617) 665-1183

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
I20210127002796 MA Practitioner - Clinical Psychologist 5991119273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

44 Barefoot Rd
Suite 300
Northborough, MA 01532-1563
Phone (781) 551-0999

89 Access Rd
Suite 24
Norwood, MA 02062-5233
Phone (781) 551-0999

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Psychologist CurrentSince Nov 1, 2020 Accepting new patients

Locations

44 Bearfoot Rd
Ste 300
Northborough, MA 01532
Phone (312) 316-0410

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

169 Libbey Park
Weymouth, MA 02189
Phone (508) 238-7766

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": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1528404332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 ACCESS RD STE 24",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625233",
            "telephone_number": "781-551-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 ACCESS RD STE 24",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625233",
            "telephone_number": "815-551-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1493 Cambridge St",
            "address_2": "Cambridge Health Alliance",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021391047",
            "country_code": "US",
            "telephone_number": "617-665-1183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KU",
        "first_name": "ELYSSA",
        "middle_name": "BRIANN WEBER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "11387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.