Active NPI
Katherine Dellaporta, PSY.D.
- Psychologist
- Boston, MA
National Provider Identifier
1396052940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 10092
- Practice address
- 121 Mount Vernon St Ste 22
Boston, MA 02108-1104 - Phone
- (585) 704-4799
- NPI assigned
- Sep 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 10092 | MA | |
| Psychologist | 103T00000X | 10092 | MA | Primary |
Addresses
Primary practice location
121 Mount Vernon St Ste 22
Boston, MA 02108-1104
Mailing address
395 Marlborough St Apt 9
Boston, MA 02115-1536
Phone (585) 704-4799
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 713898 | Other | MA | TUFTS HEALTH CARE |
| 1307592 | Medicaid | MA | |
| 98179101 | Other | MA | NETWORK HEALTH |
| 1000930 | Other | MA | NHP |
| 1000930 | Other | MA | BMCHP |
| 33-0538634 | Other | MA | UNITED BEHAVIORAL HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10092 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686182400000",
"number": "1396052940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "395 MARLBOROUGH ST APT 9",
"city": "BOSTON",
"state": "MA",
"postal_code": "021151536",
"telephone_number": "585-704-4799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 MOUNT VERNON ST STE 22",
"city": "BOSTON",
"state": "MA",
"postal_code": "021081104",
"telephone_number": "585-704-4799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELLAPORTA",
"first_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-02",
"last_updated": "2023-06-08",
"certification_date": "2023-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10092",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "10092",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH CARE",
"identifier": "713898",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1307592",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NETWORK HEALTH",
"identifier": "98179101",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "1000930",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMCHP",
"identifier": "1000930",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "33-0538634",
"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 Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.