Individual provider Active NPI

Julia Ann Koretski

  • Psychiatry Physician
  • Newton, MA
National Provider Identifier
1518463512
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
290977 Issued in MA
Practice address
2014 Washington St
Newton, MA 02462-1607
Phone
(617) 243-6000
NPI assigned
Mar 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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 290977 MA Primary

Addresses

Primary practice location

2014 Washington St
Newton, MA 02462-1607

Mailing address

2014 Washington St
Newton, MA 02462-1607

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
I20220916002466 MA Practitioner - Psychiatry 0941559785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Connecticut School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

Hospital & facility affiliations

  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jun 28, 2022 Accepting new patients
Newton-Wellesley Hospital Past Accepting new patients

Locations

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1518463512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024621607",
            "telephone_number": "617-243-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORETSKI",
        "first_name": "JULIA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "290977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

Verify at the official NPI Registry.