Karsten Dirk Kueppenbender, M.D., C.G.P.

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

219749 Issued in MA

Practice address

1130 Massachusetts Ave
Third Floor
Cambridge, MA 02138-5204

Phone

(617) 855-3966

Fax

(617) 441-8303

NPI assigned

Jun 23, 2006

Last updated

Aug 14, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kueppenbender.karsten.mcl@direct.partners.masshiway.net

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.

• North Suffolk Community Services Inc.

  • Clinic/Center
  • East Boston, MA
  • NPI 1740209881
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1265468292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 MASSACHUSETTS AVE",
            "address_2": "THIRD FLOOR",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385204",
            "telephone_number": "617-855-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 MASSACHUSETTS AVE",
            "address_2": "THIRD FLOOR",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385204",
            "telephone_number": "617-855-3966",
            "fax_number": "617-441-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEPPENBENDER",
        "first_name": "KARSTEN",
        "middle_name": "DIRK",
        "credential": "M.D., C.G.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MA",
            "license": "219749",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "219749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J29279",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Eric Krutiak, PHARMD, RPH
• Carla Kruyff Arciniega, MS, DMD
• Paula Krzywicki, RDN, LDN
• James C Ku, MD
• William Kubik
• Cassandra Kugler, CNM, WHNP-BC
• Ragini Kulathila
• Deborah Beth Kulick, M.D.
• Melinda Eileen Kulish, PH.D.
• Robert Kulunis, RPH

• Addiction Medicine (Psychiatry & Neurology) Physician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.