Individual provider Active NPI

Emily Lauren Kellogg, MD

  • Obstetrics & Gynecology Physician
  • Roxbury, MA
National Provider Identifier
1053841171
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
286729 Issued in MA
Practice address
45 Dimock St
Roxbury, MA 02119-1208
Phone
(617) 442-8800
Fax
(617) 541-8334
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 286729 MA Primary

Addresses

Primary practice location

45 Dimock St
Roxbury, MA 02119-1208

Mailing address

290 Commonwealth Ave Apt B
Boston, MA 02115-2403
Phone (315) 767-2322

Other practice location 1

800 Washington St
Dept of OB/GYN
Boston, MA 02111
Phone (617) 636-0265

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
I20210910001984 MA Practitioner - Obstetrics/Gynecology 1355614546 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dimock Community Health Center, Inc.Group PAC ID 7012810492, shared by 2 NPIs, 43 clinicians

Practice addresses (Care Compare)

1340 Boylston St
Boston, MA 02215-4302
Phone (617) 267-0900

45 Dimock St
Roxbury, MA 02119-1208
Phone (617) 442-8800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
286729MAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fenway Community Health Center, Inc CurrentSince Mar 16, 2026 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Obstetrics & Gynecology CurrentSince Aug 1, 2021 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Fenway Community Health Center, Inc CurrentSince Mar 16, 2026 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2021 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients
Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce Past Accepting new patients
Beth Israel Deaconess Medical Center, Inc. Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1340 Boylston St
Boston, MA 02215
Phone (617) 267-0900

330 Brookline Ave
Fl 8
Boston, MA 02215
Phone (617) 667-3736

55 Dimock St
Roxbury, MA 02119

45 Dimock St
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: ekellogg133237@direct.bilh.masshiway.net

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1053841171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 COMMONWEALTH AVE APT B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021152403",
            "telephone_number": "315-767-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191208",
            "telephone_number": "617-442-8800",
            "fax_number": "617-541-8334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Washington St",
            "address_2": "Dept of OB/GYN",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02111",
            "country_code": "US",
            "telephone_number": "617-636-0265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "EMILY",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "286729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.