Active NPI
Marta B. Majczak, M.D.
- Child & Adolescent Psychiatry Physician
- Providence, RI
National Provider Identifier
1902009376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD13934
- Practice address
- 154 Waterman St
Suite 8
Providence, RI 02906-3116 - Phone
- (860) 690-9006
- Fax
- (401) 272-0286
- NPI assigned
- Jun 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD13934 | RI | Primary |
Addresses
Primary practice location
154 Waterman St
Suite 8
Providence, RI 02906-3116
Mailing address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1496
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD13934 | Other | RI | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 6, 2022 through Jan 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD13934 | RI | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1902009376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 VETERANS MEMORIAL PKWY",
"city": "RIVERSIDE",
"state": "RI",
"postal_code": "029155061",
"telephone_number": "401-432-1496",
"fax_number": "401-432-1524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 WATERMAN ST",
"address_2": "SUITE 8",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029063116",
"telephone_number": "860-690-9006",
"fax_number": "401-272-0286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAJCZAK",
"first_name": "MARTA",
"middle_name": "B.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-06",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "RI",
"license": "MD13934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "MD13934",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.