Julia Fomicheva, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

9255 Issued in MA

Practice address

411 Waverley Oaks Rd., #104
Waltham, MA 02452-8449

Phone

(781) 330-3092

Fax

(781) 893-1171

NPI assigned

Oct 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011

Merit-based Incentive Payment System (MIPS)

Final score

91.27 of 100Reported as group

Quality

77.51

Promoting interoperability

100

Improvement activities

40

Cost

76.72

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfomicheva86157@direct.challiance.masshiway.net

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.

• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  Medicare reassignment Care Compare group NPD
• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1932313228
  NPD
• Protestant Guild for Human Services, Inc.

  • Community/Behavioral Health Agency
  • Concord, MA
  • NPI 1295944353
  NPD (past)

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

• Cambridge Public Health Commission

  • Clinic/Center
  • Cambridge, MA
  • NPI 1306908405

  Hospital

  Care Compare affiliation
• Cambridge Public Health Commission

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1487603585
  Care Compare affiliation

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1992015275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O.BOX 79157",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024790157",
            "telephone_number": "617-826-0241",
            "fax_number": "617-826-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WAVERLEY OAKS RD., #104",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024528449",
            "telephone_number": "781-330-3092",
            "fax_number": "781-893-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMICHEVA",
        "first_name": "JULIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Waltham, MA
• Providers in Waltham, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.