Individual provider Active NPI

Marc Schwendemann, PSYD

  • Clinical Psychologist
  • Medford, MA
National Provider Identifier
1922669902
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY10000100 Issued in MA
Practice address
26 City Hall Mall
Medford, MA 02155-4754
Phone
(781) 306-5463
NPI assigned
Jun 21, 2019
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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 PSY10000100 MA Primary

Addresses

Primary practice location

26 City Hall Mall
Medford, MA 02155-4754

Mailing address

26 City Hall Mall
Medford, MA 02155-4754

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
I20240117000649 MA Practitioner - Clinical Psychologist 1153773007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

26 City Hall Mall
Medford, MA 02155-4754
Phone (781) 306-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Psychologist CurrentSince Jan 15, 2024 Accepting new patients
Atrius Health, Inc. CurrentSince Jan 15, 2024 Accepting new patients
Atrius Health, Inc. Current Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

26 City Hall Mall
Medford, MA 02155
Phone (781) 306-5100

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": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1922669902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CITY HALL MALL",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554754",
            "telephone_number": "781-306-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWENDEMANN",
        "first_name": "MARC",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY10000100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.