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STEPHEN CRAWFORD IKEDA M.D. NPI 1619900198


NPI Information

NPI: 1619900198
Provider Name: STEPHEN CRAWFORD IKEDA, M.D.
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
64 INDUSTRIAL PARK RD
PLYMOUTH, MA
ZIP 02360
Phone: (617) 847-1950
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Stephen Crawford Ikeda, M.D. is a child and adolescent psychiatry psychiatry neurology in Plymouth, MA with 35 years of experience. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Stephen Crawford Ikeda, M.D. NPI is 1619900198. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INDIANA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

64 INDUSTRIAL PARK RD
PLYMOUTH, MA
ZIP 02360-881
Phone: (617) 847-1950
Fax: (617) 774-1490

The NPI 1619900198 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 12/20/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084P0800XPsychiatry & NeurologyPsychiatry73133MASSACHUSETTSNo
22084P0802XPsychiatry & NeurologyAddiction Psychiatry73133MASSACHUSETTSNo
32084P0804XPsychiatry & NeurologyChild & Adolescent Psychiatry73133MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1J11337MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
2E91387MEDICARE UPINMASSACHUSETTS
3J11337OTHERMASSACHUSETTSBLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.