Individual provider Active NPI

Richard Thomas Monahan, PH.D.

  • Clinical Psychologist
  • Sudbury, MA
National Provider Identifier
1891721809
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 1367 Issued in MA
Practice address
147 Powers Rd
Sudbury, MA 01776-1043
Phone
(508) 653-6518
Fax
(978) 443-9660
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
Yes

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
Clinical Psychologist 103TC0700X PSY 1367 MA Primary

Addresses

Primary practice location

147 Powers Rd
Sudbury, MA 01776-1043

Mailing address

147 Powers Rd
Sudbury, MA 01776-1043
Phone (508) 653-6518

Other identifiers 3

IdentifierTypeStateIssuer
0507512MedicaidMA
712076OtherMATUFTS HEALTH PLAN
W01236OtherMABLUE CROSS BLUE SHIELD

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
I20101109001477 MA Practitioner - Clinical Psychologist 0446445001 Practice locations: Natick, MA; Sudbury, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

147 Powers Rd
Sudbury, MA 01776-1043
Phone (508) 653-6518

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 1367MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891721809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 POWERS RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761043",
            "telephone_number": "508-653-6518",
            "fax_number": "978-443-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 POWERS RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761043",
            "telephone_number": "508-653-6518",
            "fax_number": "978-443-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONAHAN",
        "first_name": "RICHARD",
        "middle_name": "THOMAS",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY 1367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0507512",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "712076",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W01236",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sudbury, MA

Sources for this page

Verify at the official NPI Registry.