Active NPI
Robert F Broussard, DMIN
- Psychologist
- Topsfield, MA
National Provider Identifier
1609952498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2449
- Practice address
- 462 Boston Street
Suite 7
Topsfield, MA 01983-1200 - Phone
- (978) 887-2448
- Fax
- (978) 774-9218
- NPI assigned
- Oct 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2449 | MA | Primary |
Addresses
Primary practice location
462 Boston Street
Suite 7
Topsfield, MA 01983-1200
Mailing address
462 Boston Street
Suite 7
Topsfield, MA 01983-1200
Phone (978) 887-2448
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W02596 | Other | MA | BLUE CROSS BLUE SHIELD |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100929001644 | MA | Practitioner - Clinical Psychologist | 3173649894 | Practice locations: Topsfield, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
462 Boston St
Suite 7
Topsfield, MA 01983-1200
Phone (978) 887-2448
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609952498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "462 BOSTON STREET",
"address_2": "SUITE 7",
"city": "TOPSFIELD",
"state": "MA",
"postal_code": "019831200",
"telephone_number": "978-887-2448",
"fax_number": "978-774-9218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "462 BOSTON STREET",
"address_2": "SUITE 7",
"city": "TOPSFIELD",
"state": "MA",
"postal_code": "019831200",
"telephone_number": "978-887-2448",
"fax_number": "978-774-9218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSARD",
"first_name": "ROBERT",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "DMIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "2449",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "W02596",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Topsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.