Individual provider Active NPI

Mary Margaret Gleason, MD

  • Child & Adolescent Psychiatry Physician
  • Boston, MA
National Provider Identifier
1023136389
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
1021055 Issued in MA
Practice address
300 Longwood Ave
Boston, MA 02115-5737
Phone
(617) 355-6000
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 0101268163 VA
Child & Adolescent Psychiatry Physician 2084P0804X 1021055 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Boston, MA 02115-5737

Mailing address

300 Longwood Ave
Boston, MA 02115-5737
Phone (617) 355-6000

Other practice location 1

2 Brookline Pl
Brookline, MA 02445-7230
Phone (617) 355-6000

Other practice location 2

333 Longwood Ave
Boston, MA 02115-5711
Phone (617) 355-7476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200211002124 VA Practitioner - Psychiatry 9032219969 Reassigns benefits to 1 organization
I20241025003033 MA Practitioner - Psychiatry 9032219969 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1021055MAMDChild & Adolescent Psychiatry Physician
0101268163VAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Jan 1, 2020 Accepting new patients
Richmond Psychiatry Group Practice Child & Adolescent Psychiatry CurrentSince Nov 1, 2024 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

400 Gresham Dr
Norfolk, VA 23507
Phone (757) 627-7301

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

400 Gresham Dr
Ste 301
Norfolk, VA 23507
Phone (757) 668-8866

Interoperability endpoints

  • Direct secure messaging: mgleason266939@direct.bostonchildrens.org

Organizations & group practices 4

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1023136389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155737",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155737",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Brookline Pl",
            "address_purpose": "LOCATION",
            "city": "Brookline",
            "state": "MA",
            "postal_code": "024457230",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155711",
            "country_code": "US",
            "telephone_number": "617-355-7476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLEASON",
        "first_name": "MARY MARGARET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101268163",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "1021055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.