Active NPI
Magdalena Wojtowicz, PHD
- Psychologist
- Boston, MA
National Provider Identifier
1750786653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10401
- Practice address
- Home Base Program
101 Merrimac Street, 2ND Floor
Boston, MA 02114 - Phone
- (617) 726-2000
- NPI assigned
- Nov 4, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MA | ||
| Psychologist | 103T00000X | 10401 | MA | Primary |
Addresses
Primary practice location
Home Base Program
101 Merrimac Street, 2ND Floor
Boston, MA 02114
Mailing address
Home Base Program
101 Merrimac Street, 2ND Floor
Boston, MA 02114
Phone (617) 726-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10401 | MA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479254400000",
"number": "1750786653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HOME BASE PROGRAM",
"address_2": "101 MERRIMAC STREET, 2ND FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HOME BASE PROGRAM",
"address_2": "101 MERRIMAC STREET, 2ND FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOJTOWICZ",
"first_name": "MAGDALENA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-04",
"last_updated": "2016-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "10401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.