Individual provider Active NPI

John Andrew Rainier Grimaldi Jr., M.D.

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1720027832
Registry record updated Jun 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
242094 Issued in MA
Practice address
221 Longwood Ave
RF-M56
Boston, MA 02115-5804
Phone
(617) 732-6753
Fax
(617) 732-8703
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 242094 MA Primary

Addresses

Primary practice location

221 Longwood Ave
RF-M56
Boston, MA 02115-5804

Mailing address

111 Cypress St
Brookline, MA 02445-6002
Phone (857) 307-0896

Other identifiers 1

IdentifierTypeStateIssuer
9724541MedicaidMA

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
I20091208000252 MA Practitioner - Psychiatry 1658472071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Vanderbilt University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

221 Longwood Ave
Boston, MA 02115-5804
Phone (617) 732-5500

Hospital & facility affiliations

  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242094MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women'S Hospital Current Accepting new patients

Locations

75 Francis St
Boston, MA 02115

Interoperability endpoints

  • Direct secure messaging: grimaldi.john.bwh@direct.partners.masshiway.net

Organizations & group practices 2

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340496000000",
    "number": "1720027832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CYPRESS ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456002",
            "telephone_number": "857-307-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LONGWOOD AVE",
            "address_2": "RF-M56",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155804",
            "telephone_number": "617-732-6753",
            "fax_number": "617-732-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMALDI",
        "first_name": "JOHN",
        "middle_name": "ANDREW RAINIER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2012-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "242094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9724541",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.