Individual provider Active NPI

Philip D Altekruse, M.D.

  • Psychiatry Physician
  • Quincy, MA
National Provider Identifier
1255354049
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
57260 Issued in MA
Practice address
859 Willard St
Suite 430
Quincy, MA 02169-7482
Phone
(617) 847-1950
Fax
(617) 774-1490
NPI assigned
Jul 25, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 57260 MA Primary
Child & Adolescent Psychiatry Physician 2084P0804X 57260 MA

Addresses

Primary practice location

859 Willard St
Suite 430
Quincy, MA 02169-7482

Mailing address

19 Longfellow Rd
Cambridge, MA 02138-4737
Phone (617) 576-0699

Other identifiers 1

IdentifierTypeStateIssuer
Y02415OtherMABLUE CROSS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050429000355 MA Practitioner - Psychiatry 8426097395 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Aug 28, 2011 Accepting new patients
Riverside Community Care, Inc. CurrentSince Aug 28, 2011 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

270 Bridge St
Ste 301
Dedham, MA 02026
Phone (617) 564-8799

190 Lenox St
Norwood, MA 02062
Phone (781) 769-8670

500 Victory Rd
Quincy, MA 02171
Phone (617) 774-1040

859 Willard St
Ste 430
Quincy, MA 02169
Phone (617) 847-1909

Interoperability endpoints

  • Direct secure messaging: philipaltekruse@ssmh.netsmartdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1255354049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LONGFELLOW RD",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384737",
            "telephone_number": "617-576-0699",
            "fax_number": "617-774-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 WILLARD ST",
            "address_2": "SUITE 430",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697482",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTEKRUSE",
        "first_name": "PHILIP",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "57260",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "57260",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y02415",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.