Individual provider Active NPI

Kristina Marie Brumme, MD

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • Boston, MA
National Provider Identifier
1457764284
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
License
291355 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(781) 799-2621
NPI assigned
Jun 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A149580 CA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X DR.0064589 CO
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 291355 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

55 Fruit St
Boston, MA 02114-2621

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 848-0000

Other practice location 2

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-8800

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
I20220601000598 MA Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 5799066718 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Pediatric Medicine
Education
Boston University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
291355MAMDPediatric Emergency Medicine (Emergency Medicine) Physician
A149580CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group, Inc. CurrentSince Jan 1, 2025 Accepting new patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Jun 15, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Jun 15, 2022 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Pediatrics CurrentSince Oct 5, 2022 Accepting new patients

Locations

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5075
San Diego, CA 92123
Phone (858) 966-8036

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

47 Middlesex Tpke
Burlington, MA 01803
Phone (857) 282-8100

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: brumme.kristina.mgh@direct.partners.masshiway.net

Organizations & group practices 5

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1457764284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "781-799-2621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-848-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3020 Childrens Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92123",
            "country_code": "US",
            "telephone_number": "858-966-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUMME",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A149580",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CO",
            "license": "DR.0064589",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "MA",
            "license": "291355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.