Active NPI
Teresa M. Kohlenberg, M.D.
- Pediatrics Physician
- Watertown, MA
National Provider Identifier
1689715658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 56098
- Practice address
- 93 Garfield St
Watertown, MA 02472-4914 - Phone
- (617) 642-1494
- NPI assigned
- Feb 10, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 56098 | MA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 56098 | MA |
Addresses
Primary practice location
93 Garfield St
Watertown, MA 02472-4914
Mailing address
93 Garfield St
Watertown, MA 02472-4914
Phone (617) 642-1494
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56098 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1689715658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "93 GARFIELD ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724914",
"telephone_number": "617-642-1494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "93 GARFIELD ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024724914",
"telephone_number": "617-642-1494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLENBERG",
"first_name": "TERESA",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-10",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "56098",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "56098",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.