NPIMap

Organization Active NPI

Boston Brain Center Inc

  • Neurorehabilitation Occupational Therapist
  • Norwood, MA
National Provider Identifier
1104693266
Registry record updated Mar 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
Legal business name
BOSTON BRAIN CENTER INC
Practice address
115 Norwood Park S Ste 108
Norwood, MA 02062-4633
Phone
(781) 757-0577
Fax
(781) 757-0570
NPI assigned
Dec 8, 2023
Last updated
Mar 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2026

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

Authorized official

Name
Ms. Andrea Kelliher, PRESIDENT / OWNER
Title
Chief Medical Officer
Phone
(781) 835-5855

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X NU Primary

Addresses

Primary practice location

115 Norwood Park S Ste 108
Norwood, MA 02062-4633

Mailing address

115 Norwood Park S Ste 108
Norwood, MA 02062-4633
Phone (781) 835-5855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240322000340 MA Part B Supplier - Clinic/Group Practice 8022455336 Receives reassigned benefits from 9 practitioners
Practice locations: Norwood, MA

National Provider Directory

National Provider Directory

Locations

115 Norwood Park S
Ste 108
Norwood, MA 02062
Phone (781) 757-0577

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772323200000",
    "number": "1104693266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NORWOOD PARK S STE 108",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624633",
            "telephone_number": "781-835-5855",
            "fax_number": "781-757-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 NORWOOD PARK S STE 108",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624633",
            "telephone_number": "781-757-0577",
            "fax_number": "781-757-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON BRAIN CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2026-03-01",
        "certification_date": "2026-03-01",
        "status": "A",
        "authorized_official_last_name": "KELLIHER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "781-835-5855",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PRESIDENT / OWNER"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.