Active NPI
Amanda J Gruber, M.D.
- Psychiatry Physician
- Somerville, MA
National Provider Identifier
1235218504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 76540
- Practice address
- 41 Russell St
Somerville, MA 02144-3023 - Phone
- (617) 832-5800
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 76540 | MA | Primary |
Addresses
Primary practice location
41 Russell St
Somerville, MA 02144-3023
Mailing address
41 Russell St
Somerville, MA 02144-3023
Phone (617) 832-5800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76540 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235218504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 RUSSELL ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021443023",
"telephone_number": "617-832-5800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 RUSSELL ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021443023",
"telephone_number": "617-832-5800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBER",
"first_name": "AMANDA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "76540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.