NPIMap

Organization Active NPI

Joseph Yeretsian, PC

Doing business as OptiMindHealth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brookline, MA
National Provider Identifier
1770055030
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
JOSEPH YERETSIAN, PC
Doing business as
OptiMindHealth
Practice address
1309 Beacon St Ste 300
Brookline, MA 02446-5252
Phone
(857) 267-8820
Fax
(617) 507-1426
NPI assigned
Dec 27, 2018
Last updated
Jan 2, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
JOSEPH YERETSIAN, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Authorized official

Name
Dr. Joseph Yeretsian, MDNPI 1003070210
Title
President
Phone
(617) 507-1472

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1309 Beacon St Ste 300
Brookline, MA 02446-5252

Mailing address

4770 Baseline Rd Ste 200
Boulder, CO 80303-2668
Phone (720) 893-0842

Other names 1

  • OptiMindHealth Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Joseph Yeretsian PC8 organizations share this tax ID, including this one
Part of
Joseph Yeretsian PC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1770055030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 BASELINE RD STE 200",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032668",
            "telephone_number": "720-893-0842",
            "fax_number": "617-507-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 BEACON ST STE 300",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465252",
            "telephone_number": "857-267-8820",
            "fax_number": "617-507-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH YERETSIAN, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOSEPH YERETSIAN, PC",
        "enumeration_date": "2018-12-27",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "YERETSIAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-507-1472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OptiMindHealth",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OptiMindHealth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.