Individual provider Active NPI

Joseph Yeretsian, M.D.

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1003070210
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
235819 Issued in MA
Practice address
361 Newbury St FL 5
Boston, MA 02115-2727
Phone
(617) 865-4910
Fax
(617) 507-1426
NPI assigned
Jul 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DR.0056212 CO
Psychiatry Physician 2084P0800X 235819 MA Primary

Addresses

Primary practice location

361 Newbury St FL 5
Boston, MA 02115-2727

Mailing address

361 Newbury St FL 5
Boston, MA 02115-2727
Phone (617) 865-4910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200318000785 CO Practitioner - Psychiatry 6002944824 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Yeretsian, P.C. CurrentSince Dec 1, 2009 Accepting new patients
Joseph Yeretsian, PC Psychiatry Past Accepting new patients
Joseph Yeretsian, PC Past Accepting new patients
Joseph Yeretsian, PC Past Accepting new patients
Joseph Yeretsian, PC Psychiatry Past Accepting new patients
Joseph Yeretsian, PC Past Accepting new patients
Joseph Yeretsian, PC Psychiatry Past Accepting new patients
Joseph Yeretsian, PC Psychiatry Past Accepting new patients

Locations

4770 Baseline Rd
Ste 300
Boulder, CO 80303
Phone (720) 798-4516

4770 Baseline Rd
Ste 200
Boulder, CO 80303
Phone (307) 840-9834

155 Boardwalk Dr
Ste 400
Fort Collins, CO 80525
Phone (970) 549-0235

20 Park Plz
Fl Fourth
Boston, MA 02116
Phone (617) 507-1472

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1003070210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 NEWBURY ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021152727",
            "telephone_number": "617-865-4910",
            "fax_number": "617-507-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 NEWBURY ST FL 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021152727",
            "telephone_number": "617-865-4910",
            "fax_number": "617-507-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YERETSIAN",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0056212",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "235819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.