Individual provider Active NPI

John P. Harkness, PSY.D.

  • Psychologist
  • Hyde Park, MA
National Provider Identifier
1891713285
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
7074 Issued in MA
Practice address
695 Truman Hwy
Hyde Park, MA 02136-3552
Phone
(617) 361-4548
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7074 MA Primary

Addresses

Primary practice location

695 Truman Hwy
Hyde Park, MA 02136-3552

Mailing address

695 Truman Hwy
Hyde Park, MA 02136-3552
Phone (617) 361-4548

Other identifiers 1

IdentifierTypeStateIssuer
1898019OtherMAMBHP

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
I20041227000416 MA Practitioner - Clinical Psychologist 5597723361 Practice locations: Hyde Park, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

695 Truman Hwy
Suite 209B
Hyde Park, MA 02136-3552
Phone (617) 361-4548

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7074MAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891713285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 TRUMAN HWY",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363552",
            "telephone_number": "617-361-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 TRUMAN HWY",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021363552",
            "telephone_number": "617-361-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKNESS",
        "first_name": "JOHN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "1898019",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyde Park, MA

Sources for this page

Verify at the official NPI Registry.