Individual provider Active NPI

Samantha Anne Minski, PHD

  • Clinical Psychologist
  • Worcester, MA
National Provider Identifier
1760830632
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10876 Issued in MA
Practice address
630 Plantation St FL Street12
Worcester, MA 01605-2038
Phone
(508) 856-0732
Fax
(508) 425-5126
NPI assigned
Jun 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Psychologist 103TC0700X 10876 MA Primary

Addresses

Primary practice location

630 Plantation St FL Street12
Worcester, MA 01605-2038

Mailing address

5 Neponset St FL Street12
Worcester, MA 01606-2714
Phone (508) 856-0732

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
I20181008003096 MA Practitioner - Clinical Psychologist 9133471840 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Apr 21, 2025 Accepting new patients
Reliant Medical Group, Inc CurrentSince Oct 15, 2018 Accepting new patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. CurrentSince Apr 21, 2025 Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

228 Billerica Rd
Chelmsford, MA 01824
Phone (978) 250-6000

5 Neponset St
#12
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

630 Plantation St
#12
Worcester, MA 01605

Interoperability endpoints

  • Direct secure messaging: sminskiphd400219@direct.atrius.masshiway.net
  • Direct secure messaging: samantha.minski.npi1760830632.reliant@direct.optumcare.masshiway.net

Organizations & group practices 4

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1760830632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL STREET12",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-856-0732",
            "fax_number": "508-425-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST FL STREET12",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052038",
            "telephone_number": "508-856-0732",
            "fax_number": "508-425-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINSKI",
        "first_name": "SAMANTHA",
        "middle_name": "ANNE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.