Individual provider Active NPI

Andrew Marshall Kuller, PSY.D.

  • Clinical Psychologist
  • Belmont, MA
National Provider Identifier
1538391602
Registry record updated Aug 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9051 Issued in MA
Practice address
115 Mill St
Recreation Building - Room 129
Belmont, MA 02478-1064
Phone
(617) 855-3899
Fax
(617) 855-3776
NPI assigned
Aug 21, 2009
Last updated
Aug 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2009

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 9051 MA Primary

Addresses

Primary practice location

115 Mill St
Recreation Building - Room 129
Belmont, MA 02478-1064

Mailing address

115 Mill St
Recreation Building - Room 129
Belmont, MA 02478-1064
Phone (617) 855-3899

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
I20091106000161 MA Practitioner - Clinical Psychologist 1850439159 Reassigns benefits to 1 organization
Practice locations: Belmont, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9051MAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Clinical CurrentSince Sep 23, 2009 Accepting new patients

Locations

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

115 Mill St
Rm 129
Belmont, MA 02478
Phone (617) 855-3899

Interoperability endpoints

  • Direct secure messaging: kuller.andrew.mcl@direct.partners.masshiway.net

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

NPI Registry JSON

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250812800000",
    "number": "1538391602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "address_2": "RECREATION BUILDING - ROOM 129",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064",
            "telephone_number": "617-855-3899",
            "fax_number": "617-855-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "address_2": "RECREATION BUILDING - ROOM 129",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064",
            "telephone_number": "617-855-3899",
            "fax_number": "617-855-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLER",
        "first_name": "ANDREW",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-21",
        "last_updated": "2009-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.