Individual provider Active NPI

Jonathan Dalton Perry, PH.D.

  • Clinical Psychologist
  • Salem, MA
National Provider Identifier
1972546414
Registry record updated Apr 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5029 Issued in MA
Practice address
81 Highland Ave
Salem, MA 01970-2714
Phone
(978) 745-9003
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2017

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 5029 MA Primary

Addresses

Primary practice location

81 Highland Ave
Salem, MA 01970-2714

Mailing address

1 Dove Ave
Salem, MA 01970-2944
Phone (978) 745-9003

Other identifiers 1

IdentifierTypeStateIssuer
0522708MedicaidMA

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
I20120508000647 MA Practitioner - Clinical Psychologist 5890957831 Practice locations: Beverly, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

800 Cummings Ctr
Suite 147U
Beverly, MA 01915-6172
Phone (978) 835-3740

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.81 of 100Reported as individual
Quality
0
Improvement activities
40
Cost
76.95

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
NSPG Billing LLC Past Accepting new patients
Shaughnessy-Kaplan Rehabilitation Hospital Inc Past Accepting new patients
Lawrence Fieman Ed D Neuropsychology 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 and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492214400000",
    "number": "1972546414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DOVE AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702944",
            "telephone_number": "978-745-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702714",
            "telephone_number": "978-745-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JONATHAN",
        "middle_name": "DALTON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2017-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "5029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0522708",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.