DR. JACQUELINE ANNE SAMSON (PH.D.) – Cognitive & Behavioral Psychologist, NPI 1467454652

DR. JACQUELINE ANNE SAMSON (PH.D.) is a healthcare provider. based in Belmont, Massachusetts. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 4522 (MA). The NPI Number for DR. JACQUELINE ANNE SAMSON (PH.D.) is 1467454652

Main info

Female
Sole Proprietor
43 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACQUELINE ANNE SAMSON (PH.D.)
NPI
1467454652
Phone
(617) 855-3348
Address
115 MILL ST
Enumeration Date
1 June 2005
Last Update Date
9 July 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6178553348
Graduation Year
1983 (43 years ago)
PAC ID
8426174822
Professional Enrollment ID
I20100922001108
Address ID
MA024781064BE115XXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:21State licenses:1Digital endpointsOther names

1,694 CLINICAL PSYCHOLOGIST in MA

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Provider Addresses for DR. JACQUELINE ANNE SAMSON (PH.D.)

  • McLean Hospital, 115, Mill Street, Kendall Gardens, Belmont, Middlesex County, Massachusetts, 02478, United States

    BELMONT, MA 024781041

    Phone: (617) 855-3348

    Fax: (617) 855-2936

    Mailing address matches the actual address.

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: 2010-09-22

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
I20100922001108IClinical 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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02478)

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Reviews

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Frequently asked questions

How do I look up DR. JACQUELINE ANNE SAMSON (PH.D.) by NPI?
Use NPI 1467454652 when you need to reference DR. JACQUELINE ANNE SAMSON (PH.D.) in forms, claims, or directories.
Is DR. JACQUELINE ANNE SAMSON (PH.D.)'s NPI currently valid?
The extract we use shows DR. JACQUELINE ANNE SAMSON (PH.D.) as active.
What does DR. JACQUELINE ANNE SAMSON (PH.D.) treat or focus on?
Patients typically see DR. JACQUELINE ANNE SAMSON (PH.D.) under the specialty Cognitive & Behavioral Psychologist. Clinical services aligned with this taxonomy classification.
What location shows for DR. JACQUELINE ANNE SAMSON (PH.D.)?
We surface Belmont, Massachusetts for DR. JACQUELINE ANNE SAMSON (PH.D.) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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