Individual provider Active NPI

Kathleen Speese, CRNP, WHNP-BC

  • Obstetrics & Gynecology Physician
  • Boston, MA
National Provider Identifier
1710633649
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
RN2375057 Issued in MA
Practice address
165 Dartmouth St
Boston, MA 02116-5123
Phone
(617) 657-6444
NPI assigned
Mar 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X SP025060 PA
Obstetrics & Gynecology Physician 207V00000X RN2375057 MA Primary

Addresses

Primary practice location

165 Dartmouth St
Boston, MA 02116-5123

Mailing address

30 Magnus Ave
Somerville, MA 02143-3807
Phone (267) 808-8996

Other names 1

  • Kathleen C Speese Professional name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326002247 MA Practitioner - Nurse Practitioner 8729455035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

142 Berkeley St
Boston, MA 02116-5100
Phone (617) 859-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2375057MAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Obstetrics & Gynecology Current Accepting new patients
Atrius Health, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Atrius Health, Inc. CurrentSince Apr 1, 2024 Accepting new patients

Locations

165 Dartmouth St
Boston, MA 02116
Phone (617) 859-5000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

Interoperability endpoints

  • Direct secure messaging: kspeesenp379794@direct.atrius.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1710633649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MAGNUS AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021433807",
            "telephone_number": "267-808-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 DARTMOUTH ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165123",
            "telephone_number": "617-657-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEESE",
        "first_name": "KATHLEEN",
        "credential": "CRNP, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "PA",
            "license": "SP025060",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "RN2375057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "SPEESE",
            "middle_name": "C",
            "credential": "CRNP, WHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.