NPIMap

Individual provider Active NPI

Robert L Wing

  • Psychologist
  • Westfield, MA
National Provider Identifier
1902082894
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3254 Issued in MA
Practice address
94 N Elm St Ste 205
Westfield, MA 01085-1641
Phone
(413) 568-0850
Fax
(413) 562-1476
NPI assigned
Jan 10, 2008
Last updated
Jan 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3254 MA Primary

Addresses

Primary practice location

94 N Elm St Ste 205
Westfield, MA 01085-1641

Mailing address

94 N Elm St Ste 205
Westfield, MA 01085-1641
Phone (413) 568-0850

Other identifiers 4

IdentifierTypeStateIssuer
0513954MedicaidMA
W03345OtherMAMEDICARE
W03345OtherMABLUE CROSS BLUE SHIELD
17783OtherHEALTH NEW ENGLAND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3254MAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Luz M. Martin, M.D. P.C. Past Accepting new patients
Bodywise Physical Therapy LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1902082894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 N ELM ST STE 205",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010851641",
            "telephone_number": "413-568-0850",
            "fax_number": "413-562-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 N ELM ST STE 205",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010851641",
            "telephone_number": "413-568-0850",
            "fax_number": "413-562-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WING",
        "first_name": "ROBERT",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0513954",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "W03345",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W03345",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "17783",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.