Individual provider Active NPI

Kamel Gherbi, M.D

  • Psychiatry Physician
  • Jamaica Plain, MA
National Provider Identifier
1174603237
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
216879 Issued in MA
Practice address
180 Morton St
Jamaica Plain, MA 02130-3735
Phone
(617) 626-9458
Fax
(617) 626-9578
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 216879 MA Primary

Addresses

Primary practice location

180 Morton St
Jamaica Plain, MA 02130-3735

Mailing address

75 Fenwood Rd
Boston, MA 02115-6103
Phone (617) 626-9458

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040807000213 MA Practitioner - Psychiatry 3678545951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

75 Fenwood Rd
Boston, MA 02115-6103
Phone (617) 626-9300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts Current Accepting new patients
Advanced Wound Recovery - Boston, LLC Past Accepting new patients

Locations

75 Fenwood Rd
Boston, MA 02115
Phone (617) 626-9300

76 Amory St
Roxbury, MA 02119
Phone (617) 626-9300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1174603237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FENWOOD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156103",
            "telephone_number": "617-626-9458",
            "fax_number": "617-626-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 MORTON ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-626-9458",
            "fax_number": "617-626-9578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHERBI",
        "first_name": "KAMEL",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "216879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica Plain, MA

Sources for this page

Verify at the official NPI Registry.