Active NPI
Raquelle Mesholam-Gately
- Psychologist
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- Massachusetts Mental Health Center
75 Fenwood Road, 5TH Floor
Boston, MA 02115 - Phone
- (617) 754-1233
- NPI assigned
- May 24, 2018
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
Massachusetts Mental Health Center
75 Fenwood Road, 5TH Floor
Boston, MA 02115
Mailing address
Massachusetts Mental Health Center
75 Fenwood Road, 5TH Floor
Boston, MA 02115
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Drexel University College of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 665-3510
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7827 | MA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cambridge Public Health Commission | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current | Accepting new patients | |
| Beth Israel Deaconess Medical Center, Inc. | Current | Accepting new patients | |
| Cambridge Public Health Commission | Current | Accepting new patients | |
| Beth Israel Deaconess Medical Center, Inc. | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current | Accepting new patients | |
| Cambridge Public Health Commission | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Current | Accepting new patients |
Locations
330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000
1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185
350 Main St
Ste 31
Malden, MA 02148
Phone (781) 397-6583
247 Station Dr
Ste NW1
Westwood, MA 02090
Phone (617) 754-1015
Interoperability endpoints
- rgately254264@direct.bilh.masshiway.net
- rmesholamgately124782@direct.challiance.masshiway.net
Organizations & group practices 9
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.
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1487603585
-
- General Acute Care Hospital
- Boston, MA
- NPI 1548202641
-
- Internal Medicine Physician
- Boston, MA
- NPI 1194765438
-
- Psychiatry Physician
- Boston, MA
- NPI 1770524373
-
- Ambulance
- Boston, MA
- NPI 1518600501
-
- Clinic/Center
- Cambridge, MA
- NPI 1306908405
-
- General Acute Care Hospital
- Cambridge, MA
- NPI 1932313228
-
- Emergency Medicine Physician
- Boston, MA
- NPI 1316987993
-
- Multi-Specialty Clinic/Center
- Boston, MA
- NPI 1679397913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527120000000",
"number": "1548751670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MASSACHUSETTS MENTAL HEALTH CENTER",
"address_2": "75 FENWOOD ROAD, 5TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MASSACHUSETTS MENTAL HEALTH CENTER",
"address_2": "75 FENWOOD ROAD, 5TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "617-754-1233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MESHOLAM-GATELY",
"first_name": "RAQUELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-24",
"last_updated": "2018-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"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 May 24, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.