Individual provider Active NPI

Melissa Kaeli

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
National Provider Identifier
1386050458
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2293194 Issued in MA
Practice address
35 South St
Boston, MA 02130-3112
Phone
(617) 286-2133
Fax
(617) 440-2081
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X RN2293194 MA Primary
Registered Nurse 163W00000X RN2293194 MA

Addresses

Primary practice location

35 South St
Boston, MA 02130-3112

Mailing address

35 South St Unit 1
Boston, MA 02130-3112
Phone (774) 239-8445

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241224000496 MA Practitioner - Nurse Practitioner 6103353578

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11 River St
Wellesley, MA 02481-2017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Colony Care Inc Single Specialty CurrentSince Dec 1, 2024 Accepting new patients
Shore Pine Psychiatry, PLLC Single Specialty Past Accepting new patients

Locations

11 River St
Wellesley Hills, MA 02481
Phone (781) 237-7979

11 River St
Ste 1
Wellesley Hls, MA 02481
Phone (508) 695-7447

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1386050458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 SOUTH ST UNIT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303112",
            "telephone_number": "774-239-8445",
            "fax_number": "508-625-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 SOUTH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303112",
            "telephone_number": "617-286-2133",
            "fax_number": "617-440-2081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAELI",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2293194",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2293194",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.