Individual provider Active NPI

Kaveh Ghaedi, D.O.

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1235576224
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1014959 Issued in MA
Practice address
101 Arch St FL 8
Boston, MA 02110-7500
Phone
(707) 932-5616
NPI assigned
May 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 1014959 MA Primary

Addresses

Primary practice location

101 Arch St FL 8
Boston, MA 02110-7500

Mailing address

5321 1St Ave S
St Petersburg, FL 33707-6101
Phone (707) 932-5616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181109001037 FL Practitioner - Psychiatry 5395768584 Reassigns benefits to 2 organizations
I20231026001571 MA Practitioner - Psychiatry 5395768584 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1014959MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Feb 12, 2024 Accepting new patients
Windmoor Healthcare Inc Psychiatry CurrentSince Jul 16, 2018 Accepting new patients
Professional Health Care of Pinellas LLC Psychiatry CurrentSince Apr 2, 2019 Accepting new patients
Cambridge Public Health Commission CurrentSince Feb 12, 2024 Accepting new patients
Professional Health Care of Pinellas Inc. CurrentSince Apr 2, 2019 Accepting new patients
Polymath Psychiatric Physicians, PLLC Psychiatry CurrentSince Jun 30, 2024 Accepting new patients

Locations

11300 US Highway 19 N
Clearwater, FL 33764
Phone (727) 541-2646

5321 1st Ave S
St Petersburg, FL 33707
Phone (707) 932-5616

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA
  • Direct secure messaging: kaveh.ghaedi@xdr.hhchealthdirect.org

Organizations & group practices 6

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": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1235576224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 1ST AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337076101",
            "telephone_number": "707-932-5616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ARCH ST FL 8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021107500",
            "telephone_number": "707-932-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHAEDI",
        "first_name": "KAVEH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-30",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "1014959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.