Individual provider Active NPI

Desiree Kiehn D'Agostino, D.C.

  • Chiropractor
  • Boston, MA
National Provider Identifier
1346232550
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1683 Issued in MA
Practice address
651 Boylston St
Suite 2
Boston, MA 02116-2846
Phone
(617) 859-9500
Fax
(617) 859-9595
NPI assigned
Aug 16, 2005
Last updated
Jul 23, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1683 MA Primary

Addresses

Primary practice location

651 Boylston St
Suite 2
Boston, MA 02116-2846

Mailing address

651 Boylston St
Suite 2
Boston, MA 02116-2846
Phone (617) 859-9500

Other identifiers 1

IdentifierTypeStateIssuer
1610635MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120109000854 MA Practitioner - Chiropractic 0547436842 Practice locations: Boston, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

651 Boylston St
Suite 2
Boston, MA 02116-2846
Phone (617) 859-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1346232550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 BOYLSTON ST",
            "address_2": "SUITE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162846",
            "telephone_number": "617-859-9500",
            "fax_number": "617-859-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 BOYLSTON ST",
            "address_2": "SUITE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021162846",
            "telephone_number": "617-859-9500",
            "fax_number": "617-859-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AGOSTINO",
        "first_name": "DESIREE",
        "middle_name": "KIEHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1610635",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.