Cynthia Medich, PHD APRN PSYCHIATRIC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

152784 Issued in MA

Practice address

529 Pearl St
Brockton, MA 02301-2825

Phone

(508) 580-2211

Fax

(508) 427-1772

NPI assigned

Oct 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Doctor of Philosophy

State licenses

Practice roles

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.

• Erickson Health Medical Group of Massachusetts PC

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1164442919
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750476412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012825",
            "telephone_number": "508-580-2211",
            "fax_number": "508-427-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012825",
            "telephone_number": "508-580-2211",
            "fax_number": "508-427-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDICH",
        "first_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "PHD APRN PSYCHIATRIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "152784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "PN0824",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Medeiros
• Medella Dental, PLLC
• Medical Oncology & Hematology, P.C.
• Medication Coordination Pharmacy LLC (Medication Coordination Pharmacy LTC)
• Medication Coordination Pharmacy LLC
• Julissa Medina
• Julia A Meehan, LICSW
• Linda M Meehan, CNS
• Nita Mehta, MD
• Srijan Mehta, D.M.D

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Brockton, MA
• Providers in Brockton, MA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.