Individual provider Active NPI

Kardeem S Joseph, MD

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1386346278
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
11 Melnea Cass Blvd
Boston, MA 02119-4401
Phone
(617) 414-2080
NPI assigned
Mar 22, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

11 Melnea Cass Blvd
Boston, MA 02119-4401

Mailing address

720 Harrison Ave Ste 914
Boston, MA 02118-2334

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
I20230809001362 MA Order and Referring Only - PsychiatryPractitioner - Psychiatry 8921460817

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Boston University Family Medicine, Inc. CurrentSince Jun 25, 2023 Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. PastSince Jun 25, 2023 Accepting new patients

Locations

720 Harrison Ave
Ste 914
Boston, MA 02118
Phone (617) 638-8540

11 Melnea Cass Blvd
Roxbury, MA 02119
Phone (617) 414-6979

Interoperability endpoints

  • Direct secure messaging: kjoseph235918@direct.bmc.masshiway.net

Organizations & group practices 3

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": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1386346278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE STE 914",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MELNEA CASS BLVD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021194401",
            "telephone_number": "617-414-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "KARDEEM",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.