Active NPI
Ellen Holtzman, PSY.D.
- Psychologist
- Nashua, NH
National Provider Identifier
1821217175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 579
- Practice address
- 16 Broad St
Nashua, NH 03064-2011 - Phone
- (603) 889-8781
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 579 | NH | Primary |
Addresses
Primary practice location
16 Broad St
Nashua, NH 03064-2011
Mailing address
40 Irving St
Melrose, MA 02176-4839
Phone (781) 665-8164
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80002457 | Medicaid | NH |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100607000562 | MA | Practitioner - Clinical Psychologist | 8729155189 | Practice locations: Wakefield, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
7 Lincoln St
Suite 304
Wakefield, MA 01880-3021
Phone (781) 245-1422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 579 | NH | MD | Psychologist |
| 4862 | MA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821217175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 IRVING ST",
"city": "MELROSE",
"state": "MA",
"postal_code": "021764839",
"telephone_number": "781-665-8164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 BROAD ST",
"city": "NASHUA",
"state": "NH",
"postal_code": "030642011",
"telephone_number": "603-889-8781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTZMAN",
"first_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NH",
"license": "579",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80002457",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashua, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.