Individual provider Active NPI

Mark William Simmons, PSY D

  • Clinical Psychologist
  • Norwood, MA
National Provider Identifier
1730265125
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY8278PR Issued in MA
Practice address
89 Access Rd
Suite 24
Norwood, MA 02062-5229
Phone
(781) 551-0999
Fax
(781) 551-3396
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY8278PR MA Primary

Addresses

Primary practice location

89 Access Rd
Suite 24
Norwood, MA 02062-5229

Mailing address

89 Access Rd
Suite 24
Norwood, MA 02062-5229
Phone (781) 551-0999

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
I20050325000525 MA Practitioner - Clinical Psychologist 7113973850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
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)

169 Libbey Industrial Pkwy
2ND
Weymouth, MA 02189-3189
Phone (781) 551-0999

89 Access Rd
Suite 24
Norwood, MA 02062-5233
Phone (781) 551-0999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY8278PRMAMDClinical Psychologist
8278MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Clinical CurrentSince Apr 1, 2011 Accepting new patients
Professional Counseling Services Inc Past Accepting new patients

Locations

89 Access Rd
Norwood, MA 02062
Phone 8888678840702

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

Interoperability endpoints

  • Direct secure messaging: cfps.marksimmons@139414.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1730265125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 ACCESS RD",
            "address_2": "SUITE 24",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625229",
            "telephone_number": "781-551-0999",
            "fax_number": "781-551-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 ACCESS RD",
            "address_2": "SUITE 24",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625229",
            "telephone_number": "781-551-0999",
            "fax_number": "781-551-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PY8278PR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.