Individual provider Active NPI

William D. Charmak, PHD

  • Clinical Psychologist
  • Nashua, NH
National Provider Identifier
1710078068
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1533 Issued in NH
Practice address
19 Tyler St Ste 103
Nashua, NH 03060-2951
Phone
(603) 577-5375
Fax
(603) 577-5609
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 03296 MD
Clinical Psychologist 103TC0700X 03296 MD
Counseling Psychologist 103TC1900X 03296 MD
Clinical Psychologist 103TC0700X 1533 NH Primary

Addresses

Primary practice location

19 Tyler St Ste 103
Nashua, NH 03060-2951

Mailing address

PO Box 3677
Nashua, NH 03061-3677
Phone (603) 577-7900

Other identifiers 5

IdentifierTypeStateIssuer
152136OtherMDVALUE OPTIONS
5339652OtherMDAETNA
36140013OtherMDCAREFIRST DC
3162004OtherMDUBH/ONE NET/MAMSI
54622502OtherMDCAREFIRST BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080606000597 MD Practitioner - Clinical Psychologist 6507936283
I20230406000080 NH Practitioner - Clinical Psychologist 6507936283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundation Medical Partners IncGroup PAC ID 9436140456, 313 clinicians

Practice addresses (Care Compare)

10 Jones Rd
Milford, NH 03055-3100
Phone (603) 672-7600

280 Main St
Nashua, NH 03060-2921

29 Northwest Blvd
Nashua, NH 03063-4068
Phone (603) 402-2070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03296MDMDClinical Psychologist
1533NHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Counseling Center P.a. Clinical CurrentSince Oct 17, 1997 Accepting new patients
Foundation Medical Partners Inc CurrentSince May 1, 2023 Accepting new patients
Foundation Medical Partners Inc. CurrentSince May 1, 2023 Accepting new patients
Robert J. Temple, MD PA Clinical Past Accepting new patients

Locations

5525 Twin Knolls Rd
Ste 327
Columbia, MD 21045
Phone (410) 992-9149

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

19 Tyler St
Ste 103
Nashua, NH 03060
Phone (603) 577-3100

Organizations & group practices 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1710078068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3677",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030613677",
            "telephone_number": "603-577-7900",
            "fax_number": "603-577-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 TYLER ST STE 103",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030602951",
            "telephone_number": "603-577-5375",
            "fax_number": "603-577-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARMAK",
        "first_name": "WILLIAM",
        "middle_name": "D.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MD",
            "license": "03296",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "03296",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MD",
            "license": "03296",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "152136",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5339652",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC",
            "identifier": "36140013",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH/ONE NET/MAMSI",
            "identifier": "3162004",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "54622502",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.