Robert Charles Portman, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3248 Issued in MA

Practice address

66 Main St
North Easton, MA 02356-1443

Phone

(508) 238-7766

Fax

(508) 230-5089

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1659309987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 MAIN ST",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561443",
            "telephone_number": "508-238-7766",
            "fax_number": "508-230-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 MAIN ST",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561443",
            "telephone_number": "508-238-7766",
            "fax_number": "508-230-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTMAN",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "3248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF MASSACHUSETTS",
            "identifier": "W03384",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "709551",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0516902",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill N Petruchik, CCC-SLP
• Cindy Pham
• Lothida Phothisane
• Susan K Plante, APRN
• Jose Roman Polanco, MD
• Robert S Powell, D.O.
• Donald P Prohovich, D.D.S.
• Mia Pruett, PH.D.
• Psychological Associates of Southeastern Massachusetts, LLC
• Jacqueline Pucillo

• Clinical Psychologist in North Easton, MA
• Providers in North Easton, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.