Active NPI
Michael Alan Jablon, EDD
- Clinical Psychologist
- Hingham, MA
National Provider Identifier
1952312860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4318
- Practice address
- 62 Derby St
Ste 13
Hingham, MA 02043 - Phone
- (781) 749-4600
- Fax
- (781) 741-8341
- NPI assigned
- Aug 10, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4318 | MA | Primary |
Addresses
Primary practice location
62 Derby St
Ste 13
Hingham, MA 02043
Mailing address
31 Gay St
Newtonville, MA 02460
Phone (617) 527-4475
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330230 | Other | MA | HARVARD PILGRIM HEALTH CA |
| 728655 | Other | MA | TUFTS HEALTH PLAN |
| W04272 | Other | MA | BCBS |
| 04343088003 | Other | MA | PACIFICARE BEHAVIORAL HEA |
| 4122160 | Other | MA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 11, 2020 through Nov 11, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4318 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952312860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 GAY ST",
"city": "NEWTONVILLE",
"state": "MA",
"postal_code": "02460",
"telephone_number": "617-527-4475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 DERBY ST",
"address_2": "STE 13",
"city": "HINGHAM",
"state": "MA",
"postal_code": "02043",
"telephone_number": "781-749-4600",
"fax_number": "781-741-8341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JABLON",
"first_name": "MICHAEL",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "EDD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "4318",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM HEALTH CA",
"identifier": "330230",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "728655",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "W04272",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICARE BEHAVIORAL HEA",
"identifier": "04343088003",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4122160",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hingham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.