Individual provider Active NPI

Lucas Wittman

  • Psychiatry Physician
  • Belmont, MA
National Provider Identifier
1891374385
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1017227 Issued in MA
Practice address
115 Mill St
Belmont, MA 02478-1064
Phone
(617) 475-0613
NPI assigned
Apr 3, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 1017227 MA Primary

Addresses

Primary practice location

115 Mill St
Belmont, MA 02478-1064

Mailing address

21 Wigglesworth St
Boston, MA 02120-1602
Phone (617) 475-0613

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250128001808 MA Practitioner - Psychiatry 4486057619 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Harvard Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The McLean Hospital CorporationGroup PAC ID 9436040961, 186 clinicians

Practice addresses (Care Compare)

115 Mill St
Belmont, MA 02478-1064
Phone (617) 855-3450

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-2551

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1017227MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Jul 1, 2025 Accepting new patients
The McLean Hospital Corporation Psychiatry CurrentSince Jun 16, 2025 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Feb 2, 2025 Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

75 Francis St
Boston, MA 02115

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Organizations & group practices 3

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": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1891374385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 WIGGLESWORTH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021201602",
            "telephone_number": "617-475-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781064",
            "telephone_number": "617-475-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTMAN",
        "first_name": "LUCAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "1017227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.