Individual provider Active NPI

Katherine Olivia Brag, M.D.

  • Dermatology Physician
  • Boston, MA
National Provider Identifier
1568857233
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
312694 Issued in LA
Practice address
330 Brooline Avenue
Gryzmish 522
Boston, MA 02215-2632
Phone
(203) 216-3833
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 312694 LA Primary

Addresses

Primary practice location

330 Brooline Avenue
Gryzmish 522
Boston, MA 02215-2632

Mailing address

330 Brooline Avenue
Gryzmish 522
Boston, MA 02215-2632
Phone (203) 216-3833

Other practice location 1

1430 Tulane Ave
SL-50
New Orleans, LA 70112-2632
Phone (504) 988-7809

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
I20200921001782 MA Practitioner - Dermatology 3678868015 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions177
Skin biopsy67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312694LAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Dermatology CurrentSince Aug 1, 2020 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2020 Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
#522
Boston, MA 02215
Phone (617) 667-3391

25 Boylston St
Ste 104
Chestnut Hill, MA 02467
Phone (617) 754-0350

Interoperability endpoints

  • Direct secure messaging: kbrag252082@direct.bilh.masshiway.net

Organizations & group practices 8

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1568857233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOLINE AVENUE",
            "address_2": "GRYZMISH 522",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152632",
            "telephone_number": "203-216-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOLINE AVENUE",
            "address_2": "GRYZMISH 522",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152632",
            "telephone_number": "203-216-3833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Tulane Ave",
            "address_2": "SL-50",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "504-988-7809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAG",
        "first_name": "KATHERINE",
        "middle_name": "OLIVIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "312694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.