Individual provider Active NPI

Scott Fish, PH.D.

  • Clinical Neuropsychologist
  • Brockton, MA
National Provider Identifier
1588938468
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
24803 Issued in CA
Practice address
940 Belmont St
Mental Health Service, BLDG. #2, Ward 22B
Brockton, MA 02301-5596
Phone
(774) 826-3189
NPI assigned
Feb 24, 2012
Last updated
Feb 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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 24803 CA Primary
Clinical Psychologist 103TC0700X 24803 CA

Addresses

Primary practice location

940 Belmont St
Mental Health Service, BLDG. #2, Ward 22B
Brockton, MA 02301-5596

Mailing address

940 Belmont St
Mental Health Service, BLDG. #2, Ward 22B
Brockton, MA 02301-5596
Phone (774) 826-3189

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
I20200204002592 MA Practitioner - Clinical Psychologist 1153553045 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-4014

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Dec 15, 2019 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Dec 15, 2019 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Dec 15, 2019 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Dec 15, 2019 Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Interoperability endpoints

  • Direct secure messaging: sfish253354@direct.bilh.masshiway.net

Organizations & group practices 6

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 1

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": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1588938468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "address_2": "MENTAL HEALTH SERVICE, BLDG. #2, WARD 22B",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "774-826-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 BELMONT ST",
            "address_2": "MENTAL HEALTH SERVICE, BLDG. #2, WARD 22B",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015596",
            "telephone_number": "774-826-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "24803",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24803",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.