NPIMap

Individual provider Active NPI

Kelly Amber Vitale, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Boston, MA
National Provider Identifier
1205331162
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
291971 Issued in MA
Practice address
830 Harrison Ave Moakley, 3Rd Floor
Solomon Center for Hema & Medical Oncology (Palliative
Boston, MA 02118
Phone
(617) 638-6428
Fax
(617) 638-5756
NPI assigned
Mar 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 275235 MA
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 291971 MA Primary

Addresses

Primary practice location

830 Harrison Ave Moakley, 3Rd Floor
Solomon Center for Hema & Medical Oncology (Palliative
Boston, MA 02118

Mailing address

801 Albany St FL G
Boston, MA 02119-3791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220802001874 MA Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 4789930355 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Internal Medicine
Education
Drexel University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Medical Foundation, Inc. Internal Medicine CurrentSince Aug 22, 2022 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jul 1, 2023 Accepting new patients
Newton Wellesley Hospital Current Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

801 Albany St
Fl G
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: vitale.kelly.nwh@direct.partners.masshiway.net
  • Direct secure messaging: kvitale175051@direct.bmc.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1205331162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE MOAKLEY, 3RD FLOOR",
            "address_2": "SOLOMON CENTER FOR HEMA & MEDICAL ONCOLOGY (PALLIATIVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-6428",
            "fax_number": "617-638-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "KELLY",
        "middle_name": "AMBER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "275235",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "MA",
            "license": "291971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.