Active NPI
Bennett Zebulun Hirsch, PHD
- Psychologist
- Wakefield, RI
National Provider Identifier
1700892908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 380
- Practice address
- 24 Salt Pond Road
Suite D-4
Wakefield, RI 02879 - Phone
- (401) 789-3694
- Fax
- (401) 789-3748
- NPI assigned
- Jul 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 380 | RI | Primary |
Addresses
Primary practice location
24 Salt Pond Road
Suite D-4
Wakefield, RI 02879
Mailing address
29 Hawthorne Rd
Jamestown, RI 02835
Phone (401) 423-1188
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6154212 | Other | RI | UNITED HEALTHCARE |
| BH08473 | Medicaid | RI | |
| 93338 | Other | RI | RI BLUE CROSS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 380 | RI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Align Physical Therapy | Current | Accepting new patients |
Locations
24 Salt Pond Rd
Ste D4
Wakefield, RI 02879
Phone (401) 667-4965
Interoperability endpoints
- lifestancehealth.bennetthirsch@151046.advancedmd-direct.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapy Clinic/Center
- Wakefield, RI
- NPI 1710367255
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700892908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 HAWTHORNE RD",
"city": "JAMESTOWN",
"state": "RI",
"postal_code": "02835",
"telephone_number": "401-423-1188",
"fax_number": "401-789-3748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 SALT POND ROAD",
"address_2": "SUITE D-4",
"city": "WAKEFIELD",
"state": "RI",
"postal_code": "02879",
"telephone_number": "401-789-3694",
"fax_number": "401-789-3748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIRSCH",
"first_name": "BENNETT",
"middle_name": "ZEBULUN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "RI",
"license": "380",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "6154212",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "BH08473",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI BLUE CROSS",
"identifier": "93338",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.