Individual provider Active NPI

John Braverman Levine, M.D.

  • Psychiatry Physician
  • Cambridge, MA
National Provider Identifier
1730206509
Registry record updated Nov 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
58949 Issued in MA
Practice address
1105 Massachusetts Ave
Suite 3D
Cambridge, MA 02138-5220
Phone
(617) 491-8022
Fax
(617) 441-8643
NPI assigned
Mar 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2011

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 58949 MA Primary

Addresses

Primary practice location

1105 Massachusetts Ave
Suite 3D
Cambridge, MA 02138-5220

Mailing address

1105 Massachusetts Ave
Suite 3D
Cambridge, MA 02138-5220
Phone (617) 491-8022

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
I20120120000676 MA Practitioner - Psychiatry 3173790888 Practice locations: Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Harvard Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1105 Massachusetts Ave
Cambridge, MA 02138-5207
Phone (617) 491-8022

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322179200000",
    "number": "1730206509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MASSACHUSETTS AVE",
            "address_2": "SUITE 3D",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385220",
            "telephone_number": "617-491-8022",
            "fax_number": "617-441-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MASSACHUSETTS AVE",
            "address_2": "SUITE 3D",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385220",
            "telephone_number": "617-491-8022",
            "fax_number": "617-441-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "JOHN",
        "middle_name": "BRAVERMAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-24",
        "last_updated": "2011-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "58949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.