Individual provider Active NPI

Susan R. Shnidman, PH.D.

  • Psychologist
  • Melrose, MA
National Provider Identifier
1689659500
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
721 Issued in MA
Practice address
50 Rowe St
Melrose Medical Center, #700
Melrose, MA 02176-3201
Phone
(781) 662-4380
Fax
(781) 665-4795
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 721 MA Primary

Addresses

Primary practice location

50 Rowe St
Melrose Medical Center, #700
Melrose, MA 02176-3201

Mailing address

11 Somerset Rd
Lexington, MA 02420-3519
Phone (781) 861-9132

Other identifiers 5

IdentifierTypeStateIssuer
W01422OtherMABLUE CROSS & BLUE SHIELD
0004532476OtherAETNA INSURANCE CO.
710247OtherMATUFTS HEALTH CARE
6170268OtherUNITED HEALTH CARE
0525618MedicaidMA

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
I20101230000034 MA Practitioner - Clinical Psychologist 4082802392 Practice locations: Melrose, MA; Lexington, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11 Somerset Rd
Lexington, MA 02420-3519
Phone (781) 861-9132

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
721MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dan-Rosenbaum Psychotherapy Associates LLC Past Accepting new patients
Maury a Goldman MD PC Past Accepting new patients

Organizations & group practices 2

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689659500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SOMERSET RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024203519",
            "telephone_number": "781-861-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ROWE ST",
            "address_2": "MELROSE MEDICAL CENTER, #700",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763201",
            "telephone_number": "781-662-4380",
            "fax_number": "781-665-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHNIDMAN",
        "first_name": "SUSAN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "W01422",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE CO.",
            "identifier": "0004532476",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH CARE",
            "identifier": "710247",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "6170268",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0525618",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.