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Active NPI 1083864946 Individual Practitioner Male Practitioner

Dr. Ethan Aaron Eisdorfer , PsyD

Psychologist - Clinical • Worcester, MA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Ethan Eisdorfer, PsyD is a certified Psychologist - Clinical practicing in Worcester, MA. With approximately 8 years of clinical experience since graduating from Rutgers New Jersey Medical School in 2018, Dr. Eisdorfer delivers high-quality medical care to the local community at 55 LAKE AVE N.

Dr. Eisdorfer is affiliated with Umass Memorial Medical Group Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include psychotherapy, psychiatric diagnostic evaluation. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

55 Lake Ave N

Worcester, MA 016550002

Telephone 5083342731
Fax 7744424672
Associated Practice Facility / Clinic
🏢 Umass Memorial Medical Center Facility NPI 1679574933

Medicare Profile & Education

Medical School

Rutgers New Jersey Medical School

Graduation Year

2018

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Clinical in Worcester, MA

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
8 Yrs -12.6 yrs vs City Avg
City Avg: 20.6 Yrs
State Avg: 29.5 Yrs
Regional Practice Density
163 Specialists

Practicing in Worcester, MA (3327 Statewide)

Telehealth Adoption Rate
19.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
55.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Eisdorfer (8 Years) 8 Yrs
Worcester Specialty Average (20.6 Years) 20.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90832 Psychotherapy, 30 minutes
91 20 $164.00 $69.86
90791 Psychiatric diagnostic evaluation
12 12 $343.00 $155.62

Medical Specialties & State Licenses

CMS Verified: 2025-03-05
Psychologist - Clinical Primary Specialty

NUCC Taxonomy Code: 103TC0700X

State License MA 11368

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.

Hospital & Practice Group Affiliations

Umass Memorial Medical Group Inc

55 Lake Ave N, Worcester, MA 016550002

Phone: 5083341000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Adepeju Champion , MD

Internal Medicine

NPI 1003090499

Doctor of Medicine (M.D.)

Dr. Julia Andrieni , MD

Internal Medicine

NPI 1003869926

Doctor of Medicine (M.D.)

Dr. Farah Mullah , DO

Family Medicine

NPI 1013935329

Doctor of Osteopathic Medicine (D.O.)

Ashley Cahill , FNP-C

Nurse Practitioner

NPI 1043010606

Family Nurse Practitioner (Certified)

Victor Acosta-Rivera

Internal Medicine

NPI 1043876634
Dr. Tracey Mohr , PsyD

Psychologist - Clinical

NPI 1053564955

Doctor of Psychology (Psy.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location March 05, 2025

Registered at 55 LAKE AVE N, WORCESTER, MA 016550002 (Tel: 5083342731)

👤
Provider Name / Credentials Updated March 05, 2025

Recorded as ETHAN EISDORFER, PSYD

📍
Updated Practice Location December 29, 2020

Registered at 151 WORCESTER RD, BARRE, MA 010059002 (Tel: 9783556321)

📍
Updated Business Mailing Address December 29, 2020

Registered at PO BOX 415348, BOSTON, MA 022415348 (Tel: 8002258885)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 29, 2020

Psychologist (License #11368 in MA)

📍
Updated Practice Location July 30, 2018

Registered at 279 LINCOLN STREET, UMMMC, HAHNEMANN FAMILY HEALTH CENTER, WORCESTER, MA 01605 (Tel: 5083348830)

📍
Updated Business Mailing Address July 30, 2018

Registered at 279 LINCOLN STREET, UMMMC, HAHNEMANN FAMILY HEALTH CENTER, WORCESTER, MA 01605 (Tel: 5083348830)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2018

Student in an Organized Health Care Education/Training Program

NPI Profile Active September 26, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location September 26, 2008

Registered at 541 MAIN STREET, SUITE 317, WEYMOUTH, MA 02190 (Tel: 7813317866)

📍
Updated Business Mailing Address September 26, 2008

Registered at 541 MAIN STREET, SUITE 317, WEYMOUTH, MA 02190 (Tel: 7813317866)

👤
Provider Name / Credentials Updated September 26, 2008

Recorded as ETHAN EISDORFER, M.A.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 26, 2008

Counselor

🟢
Initial NPI Registration & Enumeration September 26, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083864946
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 26, 2008
Last Update: March 05, 2025
Sole Proprietor: No

Mailing Address

Po Box 415348

Boston, MA 022415348

Phone: 8002258885

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.