Individual provider Active NPI

Ke Jiang

  • Mental Health Counselor
  • Lexington, MA
National Provider Identifier
1053952838
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
125 Hartwell Ave
Lexington, MA 02421-3100
Phone
(781) 861-0890
NPI assigned
Oct 3, 2019
Last updated
Oct 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

125 Hartwell Ave
Lexington, MA 02421-3100

Mailing address

95 Pleasant St
Lynn, MA 01901-1524

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240215000344 MA Practitioner - Mental Health Counselor 0244674505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eliot Community Human ServicesGroup PAC ID 2062488000, 82 clinicians

Practice addresses (Care Compare)

75 Sylvan St
Danvers, MA 01923-2763
Phone (978) 619-6850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Community Human Services Current Accepting new patients
Eliot Community Human Services CurrentSince Jan 3, 2024 Accepting new patients

Locations

75 Sylvan St
Danvers, MA 01923
Phone (978) 212-1010

125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1053952838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 PLEASANT ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 HARTWELL AVE",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024213100",
            "telephone_number": "781-861-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIANG",
        "first_name": "KE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.