Individual provider Active NPI

James Tyler Carpenter, PH.D.

  • Clinical Psychologist
  • Weymouth, MA
National Provider Identifier
1780865337
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4303 Issued in MA
Practice address
Neurobehavioral Associates
169 Libbey Parkway, 2ND Floor
Weymouth, MA 02189
Phone
(781) 682-1060
NPI assigned
Nov 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4303 MA
Clinical Psychologist 103TC0700X 4303 MA Primary

Addresses

Primary practice location

Neurobehavioral Associates
169 Libbey Parkway, 2ND Floor
Weymouth, MA 02189

Mailing address

PO Box 366063
Hyde Park, MA 02136-0019
Phone (617) 698-8350

Other identifiers 1

IdentifierTypeStateIssuer
0518018MedicaidMA

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
I20080131000146 MA Practitioner - Clinical Psychologist 7416039300 Reassigns benefits to 1 organization
Practice locations: Randolph, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metis Psychological AssociatesGroup PAC ID 9335295682, 3 clinicians

Practice addresses (Care Compare)

420 Main St
Suite 21
Walpole, MA 02081-3753
Phone (781) 963-1200

490 N Main St
Suite 2
Randolph, MA 02368-3741

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4303MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Metis Psychological Associates Psychologist CurrentSince Sep 20, 2014 Accepting new patients
Neurobehavioral Associates III, Inc Clinical PastSince May 25, 1999 Accepting new patients

Locations

490 N Main St
Ste 2
Randolph, MA 02368
Phone (781) 963-1200

420 Main St
Ste 21
Walpole, MA 02081
Phone (781) 963-1200

Organizations & group practices 2

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": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1780865337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366063",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021360019",
            "telephone_number": "617-698-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEUROBEHAVIORAL ASSOCIATES",
            "address_2": "169 LIBBEY PARKWAY, 2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02189",
            "telephone_number": "781-682-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JAMES",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4303",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "4303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0518018",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

Verify at the official NPI Registry.