Matthew E Fasano, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11129 Issued in MA

Practice address

9 Hope Ave
Waltham, MA 02453-2741

Phone

(781) 216-2100

NPI assigned

Aug 16, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Matthew Eric Fasano-McCarron Other name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Boston Neuropsychological Services, LLC

  • Clinical Neuropsychologist
  • Needham, MA
  • NPI 1407048432
  NPD

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1720634587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HOPE AVE",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532741",
            "telephone_number": "781-216-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASANO",
        "first_name": "MATTHEW",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-16",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATTHEW",
            "last_name": "FASANO-MCCARRON",
            "middle_name": "ERIC",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Abigail Fargo, LCSW
• Ahmad Farhat
• Dana Farley
• Brooks Farry, MS, ATC.
• Salome Farzaneh, DMD
• Karen Marie Fasciano, PSY.D.
• Sinclair Fashaw-Braxton
• Douglas Fecko, PT
• Nathan Feehrer
• Colleen E Feeney

• Clinical Psychologist in Waltham, MA
• Providers in Waltham, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.