Hyde Park Behavioral Health

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

HYDE PARK BEHAVIORAL HEALTH

Practice address

1234 Hyde Park Ave
Boston, MA 02136-2819

Phone

(617) 413-6618

Fax

(617) 333-8229

NPI assigned

Dec 11, 2020

Last updated

Nov 9, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clarence T Dennis, PMHNP-BCNPI 1437494267

Title

Psychiatric Nurse Practitioner

Phone

(617) 413-6618

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Tax ID family

Hyde Park Behavioral Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hyde Park Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
  • NPI 1568127157
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clarence T Dennis, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hyde Park, MA
  • NPI 1437494267
  Medicare reassignment NPD Authorized official
• Charles Joseph Dow, M.D.

  • Cardiovascular Disease Physician
  • Roxbury Crossing, MA
  • NPI 1023043874
  NPD (past)

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1639765894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 HYDE PARK AVE",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362819",
            "telephone_number": "617-413-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 HYDE PARK AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021362819",
            "telephone_number": "617-413-6618",
            "fax_number": "617-333-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "617-413-6618",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Woong Y. Hwang, MD. PHD
• You Ri Hwang
• Arooj Hyat, M.D.
• Darren J. Hyatt, MD
• Hyde Park Behavioral Health
• Emily Anne Hyde, MSN, APRN, CPNP-PC
• Eric C. Hyder, M.D.
• Omar Hyder, MD
• Chloe Marie Hylaire, NP
• Colby John Hyland

• Psychiatric/Mental Health Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.