Individual provider Active NPI

Gregg A Januszewski, PSY.D.

  • Clinical Psychologist
  • Worcester, MA
National Provider Identifier
1982611703
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7543 Issued in MA
Practice address
72 Jaques Ave
Worcester, MA 01610-2476
Phone
(508) 860-1008
NPI assigned
Aug 2, 2006
Last updated
Nov 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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 7543 MA Primary

Addresses

Primary practice location

72 Jaques Ave
Worcester, MA 01610-2476

Mailing address

309 Belmont St
Worcester, MA 01604-1059
Phone (508) 860-1008

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
I20111130000889 MA Practitioner - Clinical Psychologist 9234303264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

309 Belmont St
Worcester, MA 01604-1059
Phone (508) 368-0704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Aug 18, 2015 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Aug 18, 2015 Accepting new patients

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, 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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1982611703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041059",
            "telephone_number": "508-860-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 JAQUES AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102476",
            "telephone_number": "508-860-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANUSZEWSKI",
        "first_name": "GREGG",
        "middle_name": "A",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.