Individual provider Active NPI

Alan Marc Smith, SC.D.

  • Psychologist
  • Burlington, MA
National Provider Identifier
1669569703
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2081 Issued in MA
Practice address
101 Cambridge St 300
Burlington, MA 01803-3768
Phone
(781) 273-3399
Fax
(781) 273-3399
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2081 MA Primary

Addresses

Primary practice location

101 Cambridge St 300
Burlington, MA 01803-3768

Mailing address

41 Old Stagecoach Rd
Bedford, MA 01730-1296
Phone (781) 275-1095

Other identifiers 1

IdentifierTypeStateIssuer
0506028MedicaidMA

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
I20101005001194 MA Practitioner - Clinical Psychologist 4587856828 Reassigns benefits to 1 organization
Practice locations: Burlington, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

101 Cambridge St
Burlington, MA 01803-3768
Phone (781) 273-3399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2081MAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Lawrence Family Health Center Inc CurrentSince Jan 8, 2013 Accepting new patients
Greater Lawrence Family Health Center, Inc. Current Accepting new patients
Greater Lawrence Family Health Center Inc. CurrentSince Jan 8, 2013 Accepting new patients

Locations

150 Park St
Lawrence, MA 01841
Phone (978) 685-1770

34 Haverhill St
Lawrence, MA 01841

Organizations & group practices 3

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441152000000",
    "number": "1669569703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 OLD STAGECOACH RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301296",
            "telephone_number": "781-275-1095",
            "fax_number": "781-273-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CAMBRIDGE ST 300",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018033768",
            "telephone_number": "781-273-3399",
            "fax_number": "781-273-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ALAN",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "SC.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2015-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "2081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0506028",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.