DR. EMMA LORRAINE WEIZENBAUM (PHD) – Clinical Neuropsychologist, NPI 1225651375

DR. EMMA LORRAINE WEIZENBAUM (PHD) is a healthcare provider. based in Boston, Massachusetts. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 11981 (MA). The NPI Number for DR. EMMA LORRAINE WEIZENBAUM (PHD) is 1225651375

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. EMMA LORRAINE WEIZENBAUM (PHD)
NPI
1225651375
Phone
(617) 726-3647
Address
1 BOWDOIN SQ FL 7
Enumeration Date
23 May 2020
Last Update Date
19 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8552788009
Graduation Year
2021 (5 years ago)
PAC ID
5991168486
Group Practice PAC ID
3870405988
Professional Enrollment ID
I20230831000903
Address ID
MA021156128BO60XXXRDXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,694 CLINICAL PSYCHOLOGIST in MA

Provider Addresses for DR. EMMA LORRAINE WEIZENBAUM (PHD)

  • 1 BOWDOIN SQ FL 7

    BOSTON, MA 021142927

    Phone: (617) 726-3647

    Type: Location

  • 117 IRVING ST

    WATERTOWN, MA 024722705

    Phone: (512) 217-2825

    Type: Mailing

  • 60 FENWOOD RD

    BOSTON, MA 021156128

    Phone: (617) 525-9108

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230831000903IClinical PsychologistMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
96133Evaluation of neuropsychological test, each additional hour4411$0
90791Psychiatric diagnostic evaluation2524$0
96132Evaluation of neuropsychological test, first hour1111$0
96136Administration of psychological or neuropsychological test, first 30 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 02114)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870405988View full group profile
NameSpecialtyState
N E U R O S U R G E R YMD
-MA
Critical Care (Intensivists), Pulmonary DiseaseFL
Physician AssistantMA
N E U R O L O G YMA
Nurse PractitionerMA
Orthopedic SurgeryMA
Physician AssistantNH
Nurse PractitionerMA
P A T H O L O G YMA

Reviews

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Frequently asked questions

Does DR. EMMA LORRAINE WEIZENBAUM (PHD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. EMMA LORRAINE WEIZENBAUM (PHD) uses 1225651375.
Does the file indicate DR. EMMA LORRAINE WEIZENBAUM (PHD) is practicing under active NPI?
Directory data currently reports DR. EMMA LORRAINE WEIZENBAUM (PHD) as active.
What healthcare role does DR. EMMA LORRAINE WEIZENBAUM (PHD) hold?
Scheduling teams often label DR. EMMA LORRAINE WEIZENBAUM (PHD) under Clinical Neuropsychologist. Clinical services aligned with this taxonomy classification.
Where should I expect DR. EMMA LORRAINE WEIZENBAUM (PHD) on a map?
Expect Boston, Massachusetts as a primary anchor for DR. EMMA LORRAINE WEIZENBAUM (PHD) unless the record lists multiple sites.
Why does DR. EMMA LORRAINE WEIZENBAUM (PHD) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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