Active NPI
Judith E Krulewitz, PH.D.
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1760473441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3949-PY
- Practice address
- 545 Concord Ave
Suite 20
Cambridge, MA 02138-1125 - Phone
- (617) 818-2159
- NPI assigned
- Nov 2, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 3949-PY | MA | |
| Clinical Psychologist | 103TC0700X | 3949-PY | MA | Primary |
| Psychologist | 103T00000X | 3949-PY | MA |
Addresses
Primary practice location
545 Concord Ave
Suite 20
Cambridge, MA 02138-1125
Mailing address
4 Stony Brook Rd
Arlington, MA 02476-8019
Phone (617) 818-2159
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1899309 | Medicaid | MA | |
| 135532000 | Other | MA | MAGELLAN BEHAVIORAL HEALT |
| W03932 | Other | MA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3949-PY | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353456000000",
"number": "1760473441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 STONY BROOK RD",
"city": "ARLINGTON",
"state": "MA",
"postal_code": "024768019",
"telephone_number": "617-818-2159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 CONCORD AVE",
"address_2": "SUITE 20",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021381125",
"telephone_number": "617-818-2159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRULEWITZ",
"first_name": "JUDITH",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-02",
"last_updated": "2012-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "3949-PY",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "3949-PY",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "3949-PY",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1899309",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN BEHAVIORAL HEALT",
"identifier": "135532000",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "W03932",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.