Active NPI
Kristine Ann Mattis-Graves, M.D.
- Psychiatry Physician
- Boston, MA
National Provider Identifier
1063510147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 70429
- Practice address
- 1601 Washington St
Boston, MA 02118 - Phone
- (617) 425-2060
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 70429 | MA | Primary |
Addresses
Primary practice location
1601 Washington St
Boston, MA 02118
Mailing address
1601 Washington St
Boston, MA 02118-1951
Phone (617) 425-2060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70429 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381363200000",
"number": "1063510147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021181951",
"telephone_number": "617-425-2060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118",
"telephone_number": "617-425-2060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTIS-GRAVES",
"first_name": "KRISTINE",
"middle_name": "ANN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2013-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "70429",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.