Simon Maurice Sebastian Selwyn, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2284419 Issued in MA

Practice address

465 Waverly Oaks Rd
Waltham, MA 02452-8438

Phone

(617) 596-1975

NPI assigned

Jul 31, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

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.

• Simon Selwyn LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Belmont, MA
  • NPI 1619625753

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1821576935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 WAVERLY OAKS RD STE 416",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528401",
            "telephone_number": "617-596-1975",
            "fax_number": "781-735-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WAVERLY OAKS RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528438",
            "telephone_number": "617-596-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELWYN",
        "first_name": "SIMON",
        "middle_name": "MAURICE SEBASTIAN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2284419",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2284419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING REGISTRATION BOARD",
            "identifier": "RN2284419",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Scott
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• Anna Seitzer, LICSW
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• Nicole M. Semon, PT, DPT, PCS
• Judith W Semonoff, LICSW
• Diana Sengooba
• Serenity Mind and Wellness LLC

• Psychiatric/Mental Health Nurse Practitioner in Waltham, MA
• Providers in Waltham, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.