Individual provider Active NPI

Eric J Friedman, PHD

  • Psychologist
  • Barre, VT
National Provider Identifier
1710003793
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
048-0000341 Issued in VT
Practice address
44 Miller Rd
Barre, VT 05641-8649
Phone
(802) 479-0289
NPI assigned
Mar 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 048-0000341 VT Primary

Addresses

Primary practice location

44 Miller Rd
Barre, VT 05641-8649

Mailing address

44 Miller Rd
Barre, VT 05641-8649
Phone (802) 479-0289

Other identifiers 2

IdentifierTypeStateIssuer
00019225OtherVTBLUE CROSS BLUE SHIELD
1040890OtherVTCIGNA BEHAVIORAL HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20080208000239 VT Practitioner - Clinical Psychologist 9931282373 Practice locations: Barre, VT; Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Church St
Burlington, VT 05401-4299
Phone (802) 658-2504

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048-0000341VTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
John Roos Incorporated Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710003793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MILLER RD",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056418649",
            "telephone_number": "802-479-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 MILLER RD",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056418649",
            "telephone_number": "802-479-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "ERIC",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "048-0000341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00019225",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "1040890",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barre, VT

Sources for this page

Verify at the official NPI Registry.