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KELLY R WILSON PH.D.
NPI 1740596279
Psychologist - Clinical in Cambridge, MA

Active since August 21, 2010PECOS EnrolledAccepts Medicare Assignment
875 MASSACHUSETTS AVE, SUITE 71, CAMBRIDGE, MA 02139(857) 600-0875 Get Directions Write a Review

NPPES record last updated: January 15, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly R Wilson Ph.d. NPPES

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

KELLY R WILSON PH.D. (NPI 1740596279) is an individual clinical provider in Cambridge, Massachusetts, licensed in Massachusetts (9580) and active in the NPI registry since August 2010. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1740596279
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameKELLY R WILSONCredential: PH.D.
Location Address875 MASSACHUSETTS AVE, SUITE 71Cambridge, MA 02139-3067
Mailing Address60 Highland Ave, Apartment 1Cambridge, MA 02139-1040 · (650) 906-6177
Phone(857) 600-0875
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateAugust 21, 2010
Last NPPES UpdateJanuary 15, 2013
✔ NPI 1740596279 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 · 9580
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.
875 MASSACHUSETTS AVE, Cambridge, MA 02139
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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

Kelly R Wilson Ph.d. 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 ID9537474341
PECOS Enrollment IDI20150821013797
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02139 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
$189.86 typical visit price
range $63.72 – $189.86
Typical copayment $47.46 (range $15.93 – $47.46)
Most-billed visit code 99205
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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.

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.

ROBIN J. ALT LICSW
Social Worker (Clinical)
875 MASSACHUSETTS AVE, SUITE 41
CAMBRIDGE, MA 02139
Middlesex County (617) 547-6168
HIGHLAND PSYCHOLOGICAL ASSOCIATES, LLC
Psychologist (Clinical)
875 MASSACHUSETTS AVE, SUITE 71
CAMBRIDGE, MA 02139
Middlesex County (857) 600-0875
DR. SILVIA DOMINGUEZ PHD
Counselor (Mental Health)
875 MASSACHUSETTS AVE
CAMBRIDGE, MA 02139
Middlesex County (339) 234-5331
STEVEN HARLAN COOPER PH.D
Psychologist (Clinical)
875 MASSACHUSETTS AVE, SUITE 54
CAMBRIDGE, MA 02139
Middlesex County (617) 492-7460
HUMPHREY MORRIS M.D.
Psychiatry & Neurology (Psychiatry)
875 MASSACHUSETTS AVE, # 55
CAMBRIDGE, MA 02139
Middlesex County (617) 497-4160
STACEY SLATE PLLC
Counselor (Mental Health)
875 MASSACHUSETTS AVE
CAMBRIDGE, MA 02139
Middlesex County (617) 575-9238
TAMMY S SMITH
Counselor (Mental Health)
875 MASSACHUSETTS AVE, 25
CAMBRIDGE, MA 02139
Middlesex County (781) 832-0113
ADAM SETH KROLOFF LICSW
Social Worker (Clinical)
875 MASSACHUSETTS AVE, UNITS 84 & 85
CAMBRIDGE, MA 02139
Middlesex County (617) 354-4450

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 Kelly Wilson's NPI number?

The NPI number for Kelly Wilson is 1740596279. It was assigned to this individual provider in the NPPES registry on August 21, 2010.

Where is Kelly Wilson located?

Kelly Wilson practices at 875 Massachusetts Ave Suite 71, Cambridge, MA 02139. The listed phone number is (857) 600-0875.

What is Kelly Wilson's specialty?

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

Is Kelly Wilson enrolled in Medicare?

Yes. Kelly Wilson 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.

When was this NPI record last updated?

The NPPES record for Kelly Wilson was last updated on January 15, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.