Individual provider Active NPI

Batool Kazim, M.D.

  • Psychiatry Physician
  • Revere, MA
National Provider Identifier
1396792545
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
158453 Issued in MA
Practice address
300 Ocean Ave
MGH Healthcare Center
Revere, MA 02151
Phone
(781) 485-6109
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 158453 MA Primary

Addresses

Primary practice location

300 Ocean Ave
MGH Healthcare Center
Revere, MA 02151

Mailing address

300 Ocean Ave
MGH Healthcare Center
Revere, MA 02151
Phone (781) 485-6109

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
158453MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carson Center for Human Services, Inc. PastSince May 15, 2008 Accepting new patients
The Carson Center Past Accepting new patients

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1396792545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OCEAN AVE",
            "address_2": "MGH HEALTHCARE CENTER",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "02151",
            "telephone_number": "781-485-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OCEAN AVE",
            "address_2": "MGH HEALTHCARE CENTER",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "02151",
            "telephone_number": "781-485-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZIM",
        "first_name": "BATOOL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "158453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Revere, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.