Individual provider Active NPI

Kari Spaeth, LICSW, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dorchester, MA
National Provider Identifier
1215136841
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2320119 Issued in MA
Practice address
2100 Dorchester Ave
Dorchester, MA 02124-5615
Phone
(617) 296-4000
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2320119 MA Primary
Clinical Social Worker 1041C0700X 1026911 MA

Addresses

Primary practice location

2100 Dorchester Ave
Dorchester, MA 02124-5615

Mailing address

2100 Dorchester Ave
Dorchester, MA 02124-5615
Phone (617) 296-4000

Other practice location 1

750 Washington St
New England Medical Center
Boston, MA 02111-1526
Phone (617) 604-0094

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191009002074 MA Practitioner - Nurse Practitioner 1052471562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arbour IncGroup PAC ID 6800975574, 19 clinicians

Practice addresses (Care Compare)

49 Robinwood Ave
Boston, MA 02130-2156
Phone (617) 522-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1026911MAMDClinical Social Worker
2320119MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arbour Inc CurrentSince Oct 7, 2024 Accepting new patients
Arbour Inc CurrentSince Oct 7, 2024 Accepting new patients

Locations

49 Robinwood Ave
Jamaica Plain, MA 02130
Phone (617) 390-1204

Interoperability endpoints

  • Direct secure messaging: kspaeth@landmarkhealth-direct.org

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1215136841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-4000",
            "fax_number": "617-636-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Washington St",
            "address_2": "New England Medical Center",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111526",
            "country_code": "US",
            "telephone_number": "617-604-0094",
            "fax_number": "617-636-5138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAETH",
        "first_name": "KARI",
        "credential": "LICSW, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2320119",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1026911",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.