Individual provider Active NPI

Amy Briggs Bledsoe, PH.D.

  • Clinical Psychologist
  • Cambridge, MA
National Provider Identifier
1780606863
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8557 Issued in MA
Practice address
1208 Massachusetts Ave
Cambridge, MA 02138-3828
Phone
(617) 852-3293
NPI assigned
Jul 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 8557 MA Primary

Addresses

Primary practice location

1208 Massachusetts Ave
Cambridge, MA 02138-3828

Mailing address

15B Walnut Street
Arlington, MA 02476
Phone (617) 852-3293

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
I20090828000276 MA Practitioner - Clinical Psychologist 1759436678 Practice locations: Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1208 Massachusetts Ave
Cambridge, MA 02138-3828
Phone (617) 852-3293

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8557MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780606863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15B WALNUT STREET",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "02476",
            "telephone_number": "617-852-3293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 MASSACHUSETTS AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021383828",
            "telephone_number": "617-852-3293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "AMY",
        "middle_name": "BRIGGS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.