Rajvi Gautam Broker-Sen, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

257852 Issued in MA

Practice address

55 Hope St
Providence, RI 02906-2001

Phone

(401) 331-1350

Fax

(401) 277-3366

NPI assigned

Aug 9, 2007

Last updated

Mar 21, 2019By the provider in NPPES

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 names 1

• Rajvi Broker Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: broker-sen.rajvi.mcl@direct.partners.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The McLean Hospital Corporation

  dba McLean Professional Practice Group

  • Psychiatry Physician
  • Belmont, MA
  • NPI 1114979580
  NPD
• Anesthesiology Associates of Boro Park, LLP

  • Pain Medicine (Anesthesiology) Physician
  • Brooklyn, NY
  • NPI 1518912302
  NPD (past)
• Maimonides Department of Psychiatry FPP

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1376656710
  NPD (past)
• MMC OB-GYN Faculty Practice Plan

  • Specialist
  • Brooklyn, NY
  • NPI 1306843388
  NPD (past)

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1841481249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6688",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029406688",
            "telephone_number": "401-331-1350",
            "fax_number": "401-277-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062001",
            "telephone_number": "401-331-1350",
            "fax_number": "401-277-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKER-SEN",
        "first_name": "RAJVI",
        "middle_name": "GAUTAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "257852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAJVI",
            "last_name": "BROKER",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John G. Broderick, DMD
• Michelle J Brodeur, CRNA
• Cheryl Brodsky, M.D.
• Jeffrey M Brody, MD
• Mark Robert Brody, M.D.
• Jennifer Brondon, M.D.
• Christina Brooks
• Jessie Brooks, RN
• Fred Brosco, MD
• Cynthia Brosnan, AE

• Psychiatry Physician in Providence, RI
• Providers in Providence, RI by specialty
• Psychiatry Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.