Ethan Lindenbaum, DO

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

295145 Issued in MA

Practice address

85 Patton Rd
Devens, MA 01434-4401

Phone

(978) 615-5200

NPI assigned

Mar 26, 2020

Last updated

Jul 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Devens Treatment & Recovery Center, LLC

  dba Taravista Behavioral Health

  • Psychiatry Physician
  • Devens, MA
  • NPI 1811473267
  Medicare reassignment NPD
• Holyoke Capital JV, LLC

  dba MiraVista Behavioral Health Center

  • Psychiatric Hospital
  • Holyoke, MA
  • NPI 1649856618
  Medicare reassignment NPD
• Devens Treatment & Recovery Center, LLC

  dba TaraVista Behavioral Health Center

  • Psychiatric Hospital
  • Devens, MA
  • NPI 1063876241
  NPD (past)

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1801423983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 PATTON RD",
            "city": "DEVENS",
            "state": "MA",
            "postal_code": "014344401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 PATTON RD",
            "city": "DEVENS",
            "state": "MA",
            "postal_code": "014344401",
            "telephone_number": "978-615-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDENBAUM",
        "first_name": "ETHAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "295145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Kalugo
• Manpreet Kaur
• Sophia Khalifa
• Jean-Merimee Kouagheu
• Rebecca Lanteigne
• Julie M Macwilliams, LICSW
• Kendra Marie Maltais, LCSW
• Massachusetts Development Finance Agency (Devens Fire Department)
• Jean D. Mesquita Mello, MD
• Holly Miller

• Child & Adolescent Psychiatry Physician in Devens, MA
• Providers in Devens, MA by specialty
• Child & Adolescent Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.