Active NPI
Nancy K Gajee, PH D
- Psychologist
- Boston, MA
National Provider Identifier
1720114804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 9857
- Practice address
- 53 Parker Hill Ave
Judge Baker Children'S Center
Boston, MA 02120-3225 - Phone
- (617) 278-4254
- Fax
- (617) 278-4139
- NPI assigned
- Feb 26, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | 9857 | MA | Primary |
Addresses
Primary practice location
53 Parker Hill Ave
Judge Baker Children'S Center
Boston, MA 02120-3225
Mailing address
53 Parker Hill Ave
Judge Baker Children'S Center
Boston, MA 02120-3225
Phone (617) 278-4254
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1312677 | Medicaid | MA | |
| 685661 | Other | MA | TUFTS |
| M18708 | Other | MA | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 18, 2024 through Jul 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555286400000",
"number": "1720114804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 PARKER HILL AVE",
"address_2": "JUDGE BAKER CHILDREN'S CENTER",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203225",
"telephone_number": "617-278-4254",
"fax_number": "617-278-4139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 PARKER HILL AVE",
"address_2": "JUDGE BAKER CHILDREN'S CENTER",
"city": "BOSTON",
"state": "MA",
"postal_code": "021203225",
"telephone_number": "617-278-4254",
"fax_number": "617-278-4139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAJEE",
"first_name": "NANCY",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "PH D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2019-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "9857",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1312677",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "685661",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "M18708",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.