Active NPI
Amber A Graham
- Clinical Neuropsychologist
- Boston, MA
National Provider Identifier
1396325254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY10000668
- Practice address
- 300 Longwood Ave
Boston, MA 02115-5724 - Phone
- (617) 355-6000
- NPI assigned
- Apr 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY10000668 | MA | Primary |
Addresses
Primary practice location
300 Longwood Ave
Boston, MA 02115-5724
Mailing address
300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000
Other practice location 1
2 Brookline Pl
Brookline, MA 02445-7230
Phone (617) 355-6000
Other practice location 2
9 Hope Ave
Waltham, MA 02453-2741
Phone (781) 216-2100
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richmond Psychiatry Group Practice | Current | Accepting new patients |
Locations
300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956
Organizations & group practices 1
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.
-
- Child & Adolescent Psychiatry Physician
- Boston, MA
- NPI 1629148036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1396325254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6000"
}
],
"practiceLocations": [
{
"address_1": "2 Brookline Pl",
"address_purpose": "LOCATION",
"city": "Brookline",
"state": "MA",
"postal_code": "024457230",
"country_code": "US",
"telephone_number": "617-355-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9 Hope Ave",
"address_purpose": "LOCATION",
"city": "Waltham",
"state": "MA",
"postal_code": "024532741",
"country_code": "US",
"telephone_number": "781-216-2100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRAHAM",
"first_name": "AMBER",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-13",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "PSY10000668",
"primary": true
}
],
"identifiers": [],
"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 Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.