Active NPI
Dorian Mintzer, PH.D.
- Psychologist
- Boston, MA
National Provider Identifier
1760461271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2812
- Practice address
- 82 Marlborough St
Boston, MA 02116-2020 - Phone
- (617) 267-0285
- Fax
- (617) 232-0702
- NPI assigned
- Jan 12, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2812 | MA | Primary |
Addresses
Primary practice location
82 Marlborough St
Boston, MA 02116-2020
Mailing address
82 Marlborough St
Boston, MA 02116-2020
Phone (617) 267-0285
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040412000285 | MA | Practitioner - Clinical Psychologist | 6608860952 | Practice locations: Boston, MA; Brookline, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
82 Marlborough St
Boston, MA 02116-2020
Phone (617) 267-0585
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2812 | MA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427241600000",
"number": "1760461271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 MARLBOROUGH ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021162020",
"telephone_number": "617-267-0285",
"fax_number": "617-232-0702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 MARLBOROUGH ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021162020",
"telephone_number": "617-267-0285",
"fax_number": "617-232-0702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINTZER",
"first_name": "DORIAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-12",
"last_updated": "2015-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "2812",
"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 Mar 25, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.