Individual provider Active NPI

Kelly Kathryn Makela, DC

  • Chiropractor
  • Boston, MA
National Provider Identifier
1801550876
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3753 Issued in MA
Practice address
102 Charles St
Boston, MA 02114-4607
Phone
(617) 720-1992
NPI assigned
Oct 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3753 MA Primary

Addresses

Primary practice location

102 Charles St
Boston, MA 02114-4607

Mailing address

102 Charles St
Boston, MA 02114-4607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220323000974 MA Practitioner - Chiropractic 7810382165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles Street Family Chiropractic IncGroup PAC ID 0143226837, 2 clinicians

Practice addresses (Care Compare)

102 Charles St
Boston, MA 02114-4607
Phone (617) 905-2219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3753MAMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Street Family Chiropractic, Inc Chiropractor CurrentSince Dec 10, 2023 Accepting new patients

Locations

102 Charles St
Boston, MA 02114
Phone (617) 720-1992

Organizations & group practices 1

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": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1801550876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144607",
            "telephone_number": "617-720-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKELA",
        "first_name": "KELLY",
        "middle_name": "KATHRYN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3753",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.