Andrey Gagarin, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

154838 Issued in MA

Practice address

680 Centre St
Brockton, MA 02302-3308

Phone

(508) 941-7228

Fax

(508) 941-6401

NPI assigned

Jun 21, 2006

Last updated

Dec 7, 2011By the provider in NPPES

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

Other identifiers 1

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

Specialty

PsychiatryAlso: Geriatric Psychiatry

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Boston Health Care IncGroup PAC ID 0244218360, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Boston Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Walpole, MA
  • NPI 1821065640
  Medicare reassignment Care Compare group NPD
• Brockton Hospital, Inc.

  dba Signature Healthcare Brockton Hospital

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  NPD (past)
• Nova Psychiatric Service

  • Psychologist
  • Quincy, MA
  • NPI 1598838781
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1225074123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7228",
            "fax_number": "508-941-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7228",
            "fax_number": "508-941-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGARIN",
        "first_name": "ANDREY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "154838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1200283",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bassel Ahmed Kotb Gaballah
• Linda Gabruk
• Kimberly Gada, PT
• Rakshith Gadam, MD
• Raj A. Gadhia, M.D.
• Jaclyn A Galavotti
• Amanda Meister Gale, PA-C
• Carolyn R. Galiza, MD
• Pauline Deborah Gallagher, MA, CAGS
• Melissa Ann Gallo, PHARMD

• Psychiatry Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.