Individual provider Active NPI

Martin Randy Pierre, PH.D.

  • Counseling Psychologist
  • Dorchester Center, MA
National Provider Identifier
1962698407
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
8761 Issued in MA
Practice address
172 Ashmont St
Dorchester Center, MA 02124-3745
Phone
(617) 224-7289
Fax
(617) 524-4169
NPI assigned
Sep 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 8761 MA Primary
Health Service Psychologist 103TH0100X 8761 MA

Addresses

Primary practice location

172 Ashmont St
Dorchester Center, MA 02124-3745

Mailing address

19 Rowena St Apt 2
Dorchester Center, MA 02124-4911
Phone (617) 224-7289

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
I20080117000417 MA Practitioner - Clinical Psychologist 3870674617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ashmont Counseling Associates LLCGroup PAC ID 5991886731, 2 clinicians

Practice addresses (Care Compare)

172 Ashmont St
Dorchester, MA 02124-3745
Phone (617) 282-6700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8761MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ashmont Counseling Services Current Accepting new patients
Ashmont Counseling Associates LLC Counseling CurrentSince Jun 23, 2013 Accepting new patients

Locations

172 Ashmont St
Dorchester Center, MA 02124
Phone (617) 224-7289

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1962698407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ROWENA ST APT 2",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021244911",
            "telephone_number": "617-224-7289",
            "fax_number": "617-524-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 ASHMONT ST",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021243745",
            "telephone_number": "617-224-7289",
            "fax_number": "617-524-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "MARTIN",
        "middle_name": "RANDY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "8761",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "8761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester Center, MA

Sources for this page

Verify at the official NPI Registry.