Matthew E. Fasano, PSYD
NPI 1720634587ActiveIndividual· Psychologist, Clinical· Waltham, MA
Psychologist, Clinical (PSYD) in Waltham, Massachusetts, licensed in MA, with an NPI issued in August 2019. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1720634587 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | No |
| NPI issued | Aug 16, 2019 |
| Last updated in NPPES | Nov 6, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 11129 | MA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MA) |
|---|
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