Individual provider Active NPI

Amado F Hernandez, PH.D.

  • Clinical Neuropsychologist
  • Lynn, MA
National Provider Identifier
1619061603
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
7760 Issued in MA
Practice address
150 Market St FL 2
Lynn, MA 01901-1529
Phone
(781) 913-4017
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 7760 MA Primary

Addresses

Primary practice location

150 Market St FL 2
Lynn, MA 01901-1529

Mailing address

203 Washington St # 141
Salem, MA 01970-3607
Phone (781) 913-4017

Other practice location 1

60 Island St Ste 206
Lawrence, MA 01840-1835
Phone (781) 913-4017

Other identifiers 4

IdentifierTypeStateIssuer
1890379OtherMAMBHP
395667OtherMAMAGELLAN
1890379MedicaidMA
W06110OtherMABCBS

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
I20080218000242 MA Practitioner - Clinical Psychologist 0244313021 Practice locations: Lynn, MA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7760MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Square Therapy Associates Current Accepting new patients
Central Square Therapy Associates Current Accepting new patients
Northeast Behavioral Health Corporation Past Accepting new patients
Northeast Hospital Corporation Past Accepting new patients

Locations

60 Island St
Ste 206
Lawrence, MA 01840
Phone (781) 913-4017

150 Market St
#2
Lynn, MA 01901
Phone (781) 592-6100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776988800000",
    "number": "1619061603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 WASHINGTON ST # 141",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019703607",
            "telephone_number": "781-913-4017",
            "fax_number": "978-336-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MARKET ST FL 2",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011529",
            "telephone_number": "781-913-4017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Island St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018401835",
            "country_code": "US",
            "telephone_number": "781-913-4017",
            "fax_number": "781-658-2213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "AMADO",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "7760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "1890379",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "395667",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1890379",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "W06110",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn, MA

Sources for this page

Verify at the official NPI Registry.