Individual provider Active NPI

Daniel Epelbaum, MD

  • Psychiatry Physician
  • Derry, NH
National Provider Identifier
1538321773
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
18316 Issued in NH
Practice address
1 Parkland Dr
Derry, NH 03038-2746
Phone
(603) 421-3757
NPI assigned
Jun 30, 2008
Last updated
Apr 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 18316 NH Primary

Addresses

Primary practice location

1 Parkland Dr
Derry, NH 03038-2746

Mailing address

1 Parkand Dr
Derry, NH 03038
Phone (603) 421-3757

Other practice location 1

100 Jefferson Square
Waterbury, CT 06706-1253
Phone (203) 709-6200

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127001578 MA Practitioner - Psychiatry 7416089073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-3450

365 E St
Tewksbury, MA 01876-1950

365 E St
Tewksbury, MA 01876-1998
Phone (978) 851-7321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18316NHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Psychiatry CurrentSince Jan 19, 2021 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Dec 22, 2021 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Dec 22, 2021 Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

115 Mill St
Stop 109
Belmont, MA 02478
Phone (617) 356-8039

365 East St
Tewksbury, MA 01876
Phone (617) 536-2186

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1538321773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARKAND DR",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-421-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARKLAND DR",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382746",
            "telephone_number": "603-421-3757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Jefferson Square",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067061253",
            "country_code": "US",
            "telephone_number": "203-709-6200",
            "fax_number": "203-709-3335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EPELBAUM",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "18316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.