Individual provider Active NPI

Sandra Annette Dixon, PSY.D.

  • Clinical Psychologist
  • Arlington, MA
National Provider Identifier
1972552594
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8652 Issued in MA
Practice address
360 Massachusetts Ave
Arlington, MA 02474-6714
Phone
(781) 316-1809
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

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 8652 MA Primary

Addresses

Primary practice location

360 Massachusetts Ave
Arlington, MA 02474-6714

Mailing address

360 Massachusetts Ave
Arlington, MA 02474-6714
Phone (617) 645-5065

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
I20070515000510 MA Practitioner - Clinical Psychologist 7113021957 Practice locations: Arlington, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

360 Mass Ave
Arlington, MA 02474
Phone (781) 316-1809

360 Massachusetts Ave
Arlington, MA 02474-6714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
M. Gorman Psychological Associates Inc PastSince Aug 20, 2014 Accepting new patients

Organizations & group practices 1

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1972552594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MASSACHUSETTS AVE",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024746714",
            "telephone_number": "617-645-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MASSACHUSETTS AVE",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024746714",
            "telephone_number": "781-316-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "SANDRA",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

Verify at the official NPI Registry.