NPIMap

Individual provider Active NPI

Brandon Uchenna Ilechukwu

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1568048668
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1016085 Issued in MA
Practice address
720 Harrison Ave # Dob-915
Boston, MA 02118-2371
Phone
(617) 638-8540
NPI assigned
Mar 20, 2021
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 1016085 MA Primary

Addresses

Primary practice location

720 Harrison Ave # Dob-915
Boston, MA 02118-2371

Mailing address

720 Harrison Ave Ste 915
Boston, MA 02118-2334
Phone (617) 638-8540

Other practice location 1

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829001307 MA Practitioner - Psychiatry 5698170793 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lake Erie College of Osteopathic Medicine, Erie, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dothouse Health Inc.Group PAC ID 8729991021, 51 clinicians
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

1353 Dorchester Ave
Dorchester, MA 02122-2932
Phone (617) 288-3230

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

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts Psychiatry CurrentSince Jun 27, 2024 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Jun 27, 2024 Accepting new patients
Signature Healthcare Medical Group Inc Psychiatry CurrentSince Aug 1, 2025 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince May 25, 2024 Accepting new patients
Dothouse Health Inc. CurrentSince Sep 1, 2025 Accepting new patients
Boston University Dermatology, Inc. PastSince Mar 28, 2021 Accepting new patients

Locations

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

1353 Dorchester Ave
Dorchester, MA 02122
Phone (617) 288-3230

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

Interoperability endpoints

  • Direct secure messaging: bilechukwu140575@direct.bmc.masshiway.net
  • Direct secure messaging: brandon.ilechukwu@direct.signature.masshiway.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1568048668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE STE 915",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182334",
            "telephone_number": "617-638-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE # DOB-915",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371",
            "telephone_number": "617-638-8540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ILECHUKWU",
        "first_name": "BRANDON",
        "middle_name": "UCHENNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-20",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "1016085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.