Individual provider Active NPI

Kenneth E Martel

  • Mental Health Counselor
  • Lexington, MA
National Provider Identifier
1194075721
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1040 Waltham St
Lexington, MA 02421-8033
Phone
(781) 761-5057
Fax
(978) 186-2497
NPI assigned
Sep 11, 2012
Last updated
Sep 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MA Primary

Addresses

Primary practice location

1040 Waltham St
Lexington, MA 02421-8033

Mailing address

1040 Waltham St
Lexington, MA 02421-8033
Phone (781) 761-5057

Other identifiers 7

IdentifierTypeStateIssuer
042611055OtherMATAX ID
99618201OtherMANETWORK HEALTH
1004745OtherMANHP
1303287OtherMAMBHP
0000023532OtherMABMC
M18633OtherMABCBS
1303287MedicaidMA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200610003023 MA Practitioner - Clinical Social Worker 0749601193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Community Care IncGroup PAC ID 6709799885, 117 clinicians

Practice addresses (Care Compare)

190 Lenox St
Norwood, MA 02062-3416
Phone (781) 769-8670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Sep 11, 2023 Accepting new patients
Riverside Community Care, Inc. CurrentSince Apr 13, 2020 Accepting new patients
Atrius Health, Inc. CurrentSince Sep 11, 2023 Accepting new patients
The Edinburg Center Inc Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

270 Bridge St
Ste 301
Dedham, MA 02026
Phone (617) 564-8799

190 Lenox St
Norwood, MA 02062
Phone (781) 769-8670

1250 Hancock St
Quincy, MA 02169
Phone (617) 774-0600

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1194075721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 WALTHAM ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218033",
            "telephone_number": "781-761-5057",
            "fax_number": "978-186-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 WALTHAM ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024218033",
            "telephone_number": "781-761-5057",
            "fax_number": "978-186-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTEL",
        "first_name": "KENNETH",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "042611055",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "99618201",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "1004745",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MBHP",
            "identifier": "1303287",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC",
            "identifier": "0000023532",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M18633",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303287",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.