Peter Darrow Bishop, PHD
Individual provider Active NPI Clinical Psychologist · Chicopee, MA
NPI 1871528034 · NPPES record last updated Aug 20, 2013
Key facts
- NPI
- 1871528034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 8146 (MA)
- Practice address
- 1109 Granby Rd
Chicopee, MA 01020-1568 - Phone
- (413) 523-0900
- Fax
- (413) 523-0901
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040408000197 | MA | Practitioner - Clinical Psychologist | 3971596495 | Reassigns benefits to 1 organization |
| I20181004000607 | NY | Practitioner - Clinical Psychologist | 3971596495 |
Reassigns benefits to 2 organizations Practice locations: New York, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022345 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Knapp Street Psychiatry, PC | Clinical | Current |
Accepting new patients |
| Riverbend Medical Group, Inc | Current |
Accepting new patients | |
| Riverbend Medical Group, Inc. | Current |
Accepting new patients | |
| Che Senior Psychological Services, PC | Clinical | Current |
Accepting new patients |
| Riverbend Medical Group, Inc | Past | Accepting new patients |
Locations
232 Main St
Agawam, MA 01001
Phone (413) 789-8010
271 Carew St
Springfield, MA 01104
Phone (413) 748-9000
1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700
250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212
100 Park Ave
Fl 16
New York, NY 10017
Phone (212) 433-2384
209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625
135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8146 | MA | Yes |
Addresses
Primary practice location
1109 Granby Rd
Chicopee, MA 01020-1568
Mailing address
1109 Granby Rd
Chicopee, MA 01020-1568
Phone (413) 523-0900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1202057 | Medicaid | MA |
Other providers in Chicopee, MA
- Amanda Lynn Bialas
- Kerry Bilski
- Bio-Medical Applications of Massachusetts, Inc.
- Bionova Labs LLC
- Tori Bisciotti
- Samantha Lynn Bishop
- BJ'S Wholesale Club Inc.
- BJS Wholesale Club Inc
- Alyssa Mabel Blondin
- Heather Boettcher
All providers in Chicopee, MA · Clinical Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.