Individual provider Active NPI

Katherine A. Thayer

  • Clinical Social Worker
  • Boston, MA
National Provider Identifier
1720360134
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
120955 Issued in MA
Practice address
1 Boston Medical Center Place
Department of Outpatient Psychiatry
Boston, MA 02118-0211
Phone
(617) 414-5245
NPI assigned
Sep 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 120955 MA Primary

Addresses

Primary practice location

1 Boston Medical Center Place
Department of Outpatient Psychiatry
Boston, MA 02118-0211

Mailing address

960 Massachusetts Ave.
FL 2
Boston, MA 02118

Other practice location 1

435 Warren St
Roxbury, MA 02119-1833
Phone (617) 442-7400 ext. 2439

Other identifiers 1

IdentifierTypeStateIssuer
110144404AMedicaidMA

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180409000474 MA Practitioner - Clinical Social Worker 4183987969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University Psychiatry Associates, Inc.Group PAC ID 7911805361, 104 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-5245

85 E Newton St
Suite 905
Boston, MA 02118-2340
Phone (617) 414-5245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
120955MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Mount Auburn Hospital CurrentSince Aug 1, 2019 Accepting new patients
Boston University Psychiatry Associates, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Roxbury Comprehensive Community Health Center, Inc. PastSince Aug 21, 1997 Accepting new patients
Roxbury Comprehensive Community Health Center Past Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

85 East Newton St
Ste 905
Boston, MA 02118
Phone (617) 414-5245

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

801 Albany St
Fl G
Roxbury, MA 02119

Interoperability endpoints

  • Direct secure messaging: kthayer178731@direct.bmc.masshiway.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1720360134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE.",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CENTER PLACE",
            "address_2": "DEPARTMENT OF OUTPATIENT PSYCHIATRY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021180211",
            "telephone_number": "617-414-5245"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 Warren St",
            "address_purpose": "LOCATION",
            "city": "Roxbury",
            "state": "MA",
            "postal_code": "021191833",
            "country_code": "US",
            "telephone_number": "617-442-7400 x2439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAYER",
        "first_name": "KATHERINE",
        "middle_name": "A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-12",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110144404A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.