Katherine Kimi Miura, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

81163 Issued in MA

Practice address

100 Cummings Ctr
Suite 423-G
Beverly, MA 01915-6115

Phone

(978) 594-1662

Fax

(978) 336-5887

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Psychiatry

Education

Medical College of Wisconsin, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beth Israel Lahey Health Specialty Care, Inc.Group PAC ID 2365405024, 264 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033

Merit-based Incentive Payment System (MIPS)

Final score

91.98 of 100Reported as apm

Quality

76.59

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Beth Israel Lahey Health Specialty Care, Inc.

  • Internal Medicine Physician
  • Gloucester, MA
  • NPI 1235147760
  Medicare reassignment Care Compare group NPD
• Northeast Behavioral Health Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beverly, MA
  • NPI 1154302586
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Hospital Corporation

  • General Acute Care Hospital
  • Beverly, MA
  • NPI 1316917941
  Care Compare affiliation
• Northeast Hospital Corporation

  • Psychiatric Hospital Unit
  • Beverly, MA
  • NPI 1407827710
  Care Compare affiliation

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1801853007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 423-G",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-594-1662",
            "fax_number": "978-336-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUITE 423-G",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-594-1662",
            "fax_number": "978-336-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIURA",
        "first_name": "KATHERINE",
        "middle_name": "KIMI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "81163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 2",
            "identifier": "1457642894",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1801853007",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3156486",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystina Mistretta, PT, DPT
• Deborah Mitchell, PA-C
• Madeline Mitchell, LICSW
• Michelle Ann Mitchell
• Randi Mitchell, LICSW
• Dana Elizabeth Modell, LICSW
• Ludia Modi
• Kirsten Moll Pester, LICSW
• Adriana Margaret Mollo, RPH
• Sina Tiffany Mom-Parra, MS

• Psychiatry Physician in Beverly, MA
• Providers in Beverly, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.