DR. PAUL A CANNISTRARO (M.D.) – Psychiatry Physician, NPI 1639165988
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,743 PSYCHIATRY in MA
Provider Addresses for DR. PAUL A CANNISTRARO (M.D.)
5 JFK ST
SUITE 306
CAMBRIDGE, MA 021384916
Phone: (617) 460-1053
Fax: (617) 848-9485
Type: Mailing
12 ARROW ST STE 210
CAMBRIDGE, MA 021385105
Phone: (617) 460-1053
Fax: (617) 848-9485
Type: Mailing
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: 2004-07-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040713000533 | I | Psychiatry | MA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 252 | 26 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 252 | 26 | $0 |
Insurance plans in this area (ZIP 02138)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHIATRY | MA | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 132 | 16 |
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