Individual provider Active NPI

John Raymond Peteet, MD

  • Psychiatry Physician
  • Brookline, MA
National Provider Identifier
1033100664
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
36970 Issued in MA
Practice address
1 Brookline Place
Suite 502
Brookline, MA 02445
Phone
(617) 278-0438
Fax
(617) 632-6136
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 36970 MA Primary

Addresses

Primary practice location

1 Brookline Place
Suite 502
Brookline, MA 02445

Mailing address

75 Francis Street
Boston, MA 02115
Phone (617) 278-0438

Other identifiers 1

IdentifierTypeStateIssuer
110037675MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050511000257 MA Practitioner - Psychiatry 2062452816 Reassigns benefits to 3 organizations
Practice locations: Brookline, MA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Columbia University College of Physicians and Surgeons, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Dana-Farber Cancer Institute Hospital, Boston, MA, CCN 220162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36970MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince May 30, 2015 Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

75 Francis St
Boston, MA 02115

1 Brookline Pl
Ste 502
Brookline, MA 02445
Phone (617) 278-0438

111 Cypress St
Brookline, MA 02445
Phone (617) 582-1200

1 Brookline Pl
Ste 426
Brookline, MA 02445
Phone (617) 278-0272

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

Interoperability endpoints

  • Direct secure messaging: peteet.john.bwh@direct.partners.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1033100664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-278-0438",
            "fax_number": "617-632-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKLINE PLACE",
            "address_2": "SUITE 502",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02445",
            "telephone_number": "617-278-0438",
            "fax_number": "617-632-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETEET",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "36970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110037675",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.