Individual provider Active NPI

Gina A Forchelli, EDM

  • Clinical Psychologist
  • Boston, MA
National Provider Identifier
1932582731
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
10437 Issued in MA
Practice address
151 Merrimac St FL 5
Boston, MA 02114-4714
Phone
(617) 726-2000
NPI assigned
Jun 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MA
Clinical Psychologist 103TC0700X 10437 MA Primary

Addresses

Primary practice location

151 Merrimac St FL 5
Boston, MA 02114-4714

Mailing address

151 Merrimac St FL 5
Boston, MA 02114-4714
Phone (617) 726-2000

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
I20161207000074 MA Practitioner - Clinical Psychologist 8325328495 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10437MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

Interoperability endpoints

  • Direct secure messaging: forchelli.gina.mgh@direct.partners.masshiway.net

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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1932582731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 MERRIMAC ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144714",
            "telephone_number": "617-726-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MERRIMAC ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144714",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORCHELLI",
        "first_name": "GINA",
        "middle_name": "A",
        "credential": "EDM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.