Individual provider Active NPI

Woodrow W Havens II, M.D.

  • Psychiatry Physician
  • Brookline, MA
National Provider Identifier
1326095019
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
57097 Issued in MA
Practice address
17 Browne St
Brookline, MA 02446-3804
Phone
(617) 739-6591
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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 57097 MA Primary

Addresses

Primary practice location

17 Browne St
Brookline, MA 02446-3804

Mailing address

17 Browne St
Brookline, MA 02446-3804
Phone (617) 739-6591

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
I20041206000163 MA Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 7012973761 Practice locations: Brookline, MA; Medford, MA

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Baylor College of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17 Browne St
Brookline, MA 02446-3804
Phone (617) 739-6591

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57097MAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1326095019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BROWNE ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463804",
            "telephone_number": "617-739-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BROWNE ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463804",
            "telephone_number": "617-739-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "WOODROW",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "57097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.