Brian John Grace, PMHNP-BC, MBA, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2022010797 Issued in MA

Practice address

10 Cabot Rd Ste 201
Medford, MA 02155-5173

Phone

(800) 915-3211

NPI assigned

Jun 29, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

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.

• Serenity Telepsychiatry LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pittsfield, MA
  • NPI 1205639226

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1144952094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CABOT RD STE 201",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555173",
            "telephone_number": "800-915-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CABOT RD STE 201",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021555173",
            "telephone_number": "800-915-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "BRIAN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC, MBA, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2022010797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Ruth Goodman, PT
• Daijjah T Gordon
• Lisa Ferreira Gormley, MS, RD, LDN, CWPM
• Lynne E Gotjen
• Grace Jotika DMD PC
• Shawn Grace
• James Graham, PSY.D.
• Sara Grant, FNP
• Greater Boston Oral Surgery and Dental Implant Center PLLC (Greater Boston Oral Surgery and Dental Implant Center)
• Green Cab Co, Inc.

• Psychiatric/Mental Health Nurse Practitioner in Medford, MA
• Providers in Medford, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.