Individual provider Active NPI

John B. Levine, MD

  • Child & Adolescent Psychiatry Physician
  • Milford, MA
National Provider Identifier
1093752651
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
159761 Issued in MA
Practice address
14 Prospect Street
Milford, MA 01757-3003
Phone
(508) 482-5444
Fax
(508) 482-5408
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 46362 CT
Child & Adolescent Psychiatry Physician 2084P0804X 159761 MA Primary

Addresses

Primary practice location

14 Prospect Street
Milford, MA 01757-3003

Mailing address

124 Grove St.
Suite 305
Franklin, MA 02038-3156
Phone (508) 528-5392

Other identifiers 1

IdentifierTypeStateIssuer
110007102/AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080611000260 CT Practitioner - PsychiatryPractitioner - Neuropsychiatry 9032280557 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46362CTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Connecticut CurrentSince May 2, 2025 Accepting new patients
State of Connecticut CurrentSince May 2, 2025 Accepting new patients
Martha'S Vineyard Hospital, Inc. Past Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

Organizations & group practices 3

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1093752651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GROVE ST.",
            "address_2": "SUITE 305",
            "city": "FRANKLIN",
            "state": "MA",
            "postal_code": "020383156",
            "telephone_number": "508-528-5392",
            "fax_number": "508-541-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PROSPECT STREET",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573003",
            "telephone_number": "508-482-5444",
            "fax_number": "508-482-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "JOHN",
        "middle_name": "B.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "46362",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "159761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110007102/A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

Verify at the official NPI Registry.