Individual provider Active NPI

Laura Michelle Fedototszkin Fisher, PSYD

  • Clinical Psychologist
  • Cambridge, MA
National Provider Identifier
1871670646
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8622 Issued in MA
Practice address
PO Box 425010
Cambridge, MA 02142-0001
Phone
(617) 934-4744
Fax
(888) 252-7990
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301012594 MI
Clinical Psychologist 103TC0700X 026619-01 NY
Clinical Psychologist 103TC0700X PS02186 RI
Clinical Psychologist 103TC0700X 8622 MA Primary

Addresses

Primary practice location

PO Box 425010
Cambridge, MA 02142-0001

Mailing address

PO Box 425010
Cambridge, MA 02142-0001
Phone (617) 934-4744

Other names 1

  • Laura Michelle Fedototszkin Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071121000252 MA Practitioner - Clinical Psychologist 6901994136 Practice locations: Charlestown, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Monument SQ
Apt 1
Charlestown, MA 02129-3440
Phone (617) 934-4744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301012594MIMDClinical Psychologist
026619-01NYMDClinical Psychologist
PS02186RIMDClinical Psychologist
8622MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anadyne Psychotherapy, Inc. PastSince May 1, 2004 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1871670646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425010",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021420001",
            "telephone_number": "617-934-4744",
            "fax_number": "888-252-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 425010",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021420001",
            "telephone_number": "617-934-4744",
            "fax_number": "888-252-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "LAURA MICHELLE",
        "middle_name": "FEDOTOTSZKIN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012594",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "026619-01",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS02186",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "FEDOTOTSZKIN",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.