DR. ETHAN AARON EISDORFER PSYD
NPI 1083864946
Psychologist - Clinical in Worcester, MA

Q: What is Ethan Eisdorfer's NPI number?

The NPI number for Ethan Eisdorfer is 1083864946. It was assigned to this individual provider in the NPPES registry on September 26, 2008.

Q: What is Ethan Eisdorfer's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Eisdorfer was last updated on March 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 26, 2008PECOS EnrolledAccepts Medicare Assignment

55 LAKE AVE N, WORCESTER, MA 01655(508) 334-2731(774) 442-4672 Get Directions Write a Review

NPPES record last updated: March 5, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 5, 2025, Apr 5, 2021, Dec 29, 2020 and 1 more (4 updates tracked since 2018).

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About Dr. Ethan Aaron Eisdorfer Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETHAN AARON EISDORFER PSYD (NPI 1083864946) is an individual clinical provider in Worcester, Massachusetts, licensed in Massachusetts (11368) and active in the NPI registry since September 2008. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Medical Center/university Campus, and is a graduate of Rutgers New Jersey Medical School (2018).

NPPES Registry Identity

NPI1083864946

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. ETHAN AARON EISDORFERCredential: PSYD

Location Address55 LAKE AVE NWorcester, MA 01655-0002

Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885

Phone(508) 334-2731

Fax(774) 442-4672

Sole ProprietorNo

Medical School CMSRutgers New Jersey Medical SchoolGraduated 2018

Enumeration DateSeptember 26, 2008

Last NPPES UpdateMarch 5, 20254 updates tracked since enumeration

NPPES CertifiedMarch 5, 2025

✔ NPI 1083864946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MA · 11368

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

55 LAKE AVE N, Worcester, MA 01655

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ethan Aaron Eisdorfer Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739593872

PECOS Enrollment IDI20210201000663

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220163

Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01655 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$177.36 typical visit price

range $58.86 – $177.36

Typical copayment $44.34 (range $14.71 – $44.34)

Most-billed visit code 99205

Established Patient

$103.48 typical visit price

range $19.11 – $144.84

Typical copayment $25.87 (range $4.77 – $36.21)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HILLARY R. IRONS MD

Emergency Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 421-1400

MS. EILEEN A. DUHAMEL NP

Nurse Practitioner

55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-2710

EWA HRYNISZYN CRNA

Nurse Anesthetist, Certified Registered

55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

HELEN COPSEY PA-C

Physician Assistant

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-8585

DR. ADEPEJU GBADEBO CHAMPION M.D.

Internal Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-2731

SOWMYA KORAPATI

Internal Medicine (Hematology & Oncology)

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-3550

LAYLA FAKHRZADEH M.D.

Anesthesiology

55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

YOONYIE CHO M.D.

Anesthesiology

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Eisdorfer's NPI number?

The NPI number for Ethan Eisdorfer is 1083864946. It was assigned to this individual provider in the NPPES registry on September 26, 2008.

Where is Ethan Eisdorfer located?

Ethan Eisdorfer practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 334-2731.

What is Ethan Eisdorfer's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Ethan Eisdorfer enrolled in Medicare?

Yes. Ethan Eisdorfer is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ethan Eisdorfer accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Ethan Eisdorfer as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ethan Eisdorfer affiliated with any hospitals?

According to CMS data, Ethan Eisdorfer is affiliated with Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Ethan Eisdorfer was last updated on March 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.