Active NPI
James Mark Greenblatt, M.D
- Psychiatry Physician
- Waltham, MA
National Provider Identifier
1790817575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 70333
- Practice address
- 9 Hope Ave Ste 500
Walden Behavioral Care
Waltham, MA 02453-2751 - Phone
- (781) 647-0066
- Fax
- (781) 899-4905
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 70333 | MA | Primary |
Addresses
Primary practice location
9 Hope Ave Ste 500
Walden Behavioral Care
Waltham, MA 02453-2751
Mailing address
9 Hope Ave
Ste 500
Waltham, MA 02453-2751
Phone (781) 647-2901
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 70333 | Other | MA | LICENSE |
| RX2645 | Other | MA | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
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.
-
- Psychiatric Hospital
- Dedham, MA
- NPI 1992778781
-
- General Acute Care Hospital
- Vernon, CT
- NPI 1205283538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1790817575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 HOPE AVE",
"address_2": "STE 500",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024532751",
"telephone_number": "781-647-2901",
"fax_number": "781-647-6753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 HOPE AVE STE 500",
"address_2": "WALDEN BEHAVIORAL CARE",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024532751",
"telephone_number": "781-647-0066",
"fax_number": "781-899-4905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBLATT",
"first_name": "JAMES",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "70333",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "70333",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "RX2645",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; 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.