Individual provider Active NPI

Shaomin Xing, PHD

  • Psychologist
  • Norwood, MA
National Provider Identifier
1700993664
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7258 Issued in MA
Practice address
89 Access Rd Ste 24
Norwood, MA 02062-5233
Phone
(781) 551-0999
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7258 MA
Psychologist 103T00000X 7258 MA Primary

Addresses

Primary practice location

89 Access Rd Ste 24
Norwood, MA 02062-5233

Mailing address

91 Chestnut St Apt 5
Brookline, MA 02445-7582
Phone (617) 669-7244

Other practice location 1

460 Quincy Ave
Quincy, MA 02169-8130
Phone (617) 689-2551

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
I20050831000201 MA Practitioner - Clinical Psychologist 0446282347 Reassigns benefits to 2 organizations
Practice locations: Brookline, MA; Quincy, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

2300 Crown Colony Dr
Suite 202
Quincy, MA 02169-0902
Phone (781) 551-0999

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7258MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Nov 1, 2007 Accepting new patients
Child and Family Psychological Services, PLLC Psychologist CurrentSince Dec 1, 2019 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

460 Quincy Ave
Quincy, MA 02169
Phone (617) 770-4000

2300 Crown Colony Dr
Ste 202
Quincy, MA 02169
Phone (617) 405-5735

500 Victory Rd
Ste 19
Quincy, MA 02171
Phone (617) 774-1040

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1700993664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 CHESTNUT ST APT 5",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457582",
            "telephone_number": "617-669-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 ACCESS RD STE 24",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625233",
            "telephone_number": "781-551-0999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Quincy Ave",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021698130",
            "country_code": "US",
            "telephone_number": "617-689-2551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "XING",
        "first_name": "SHAOMIN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7258",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.