Individual provider Active NPI

Jeffrey Phillip Winer, PHD

  • Clinical Psychologist
  • Lexington, MA
National Provider Identifier
1629590443
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10965 Issued in MA
Practice address
57 Bedford St Ste 230
Lexington, MA 02420
Phone
(339) 970-8573
NPI assigned
Jul 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 10965 MA Primary

Addresses

Primary practice location

57 Bedford St Ste 230
Lexington, MA 02420

Mailing address

57 Bedford St Ste 230
Lexington, MA 02420-4502
Phone (339) 970-8573

Other practice location 1

115 Mill St
Belmont, MA 02478-1064
Phone (781) 710-9512

Other practice location 2

115 Mill St
Belmont, MA 02478-1064
Phone (781) 710-9512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10965MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1629590443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 BEDFORD ST STE 230",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204502",
            "telephone_number": "339-970-8573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BEDFORD ST STE 230",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "02420",
            "telephone_number": "339-970-8573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Mill St",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "MA",
            "postal_code": "024781064",
            "country_code": "US",
            "telephone_number": "781-710-9512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Mill St",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "MA",
            "postal_code": "024781064",
            "country_code": "US",
            "telephone_number": "781-710-9512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINER",
        "first_name": "JEFFREY",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-13",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.