Individual provider Active NPI

Alexis S Adler, PSYD

  • Psychologist
  • Arlington, MA
National Provider Identifier
1558675181
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
9951 Issued in NU
Practice address
21 Coleman Rd
Arlington, MA 02476-6217
Phone
(617) 653-0526
NPI assigned
Aug 6, 2010
Last updated
Sep 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 9951 NU Primary

Addresses

Primary practice location

21 Coleman Rd
Arlington, MA 02476-6217

Mailing address

21 Coleman Rd
Arlington, MA 02476-6217
Phone (617) 653-0526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20190326001315 ME Practitioner - Clinical Psychologist 5193947091 Practice locations: Portland, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19 S St
Suite 5
Portland, ME 04101-3963
Phone (617) 653-0526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy North, LLC Past Accepting new patients

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": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1558675181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COLEMAN RD",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024766217",
            "telephone_number": "617-653-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 COLEMAN RD",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024766217",
            "telephone_number": "617-653-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADLER",
        "first_name": "ALEXIS",
        "middle_name": "S",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-06",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": "9951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

Verify at the official NPI Registry.