Anthony J Siracusa, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3480 Issued in MA

Practice address

167 Bailey Rd
Lanesborough, MA 01237-9669

Phone

(413) 458-9601

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Anthony J Siracusa IV Professional name

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

Specialty

Clinical Psychologist

Education

Indiana University School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Siracusa Associates Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Williamstown, MA
  • NPI 1629529011
  NPD (past) Authorized official
• Williamstown Behavioral Health Associates

  • Psychologist
  • North Adams, MA
  • NPI 1417023672
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1851382808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 BAILEY RD",
            "city": "LANESBOROUGH",
            "state": "MA",
            "postal_code": "012379669",
            "telephone_number": "413-458-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 BAILEY RD",
            "city": "LANESBOROUGH",
            "state": "MA",
            "postal_code": "012379669",
            "telephone_number": "413-458-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRACUSA",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0518468",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTHONY",
            "last_name": "SIRACUSA",
            "middle_name": "J",
            "prefix": "DR.",
            "suffix": "IV",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jeffrey J Kellogg, PA, MBA
• Michael Donald O'Brien, O.D.
• Pearle Vision Inc
• Sara Scorpa
• Dana Michele Seddon, D.O.
• Isabel Stomberg, BIRTH DOULA, CLC
• Town of Lanesborough

• Psychologist in Lanesborough, MA
• Providers in Lanesborough, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.