Individual provider Active NPI

Kathryn D Roddy, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Watertown, MA
National Provider Identifier
1861252835
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2349801 Issued in MA
Practice address
173 Mount Auburn St
Watertown, MA 02472-4005
Phone
(617) 396-7434
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2349801 MA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 2349801 MA

Addresses

Primary practice location

173 Mount Auburn St
Watertown, MA 02472-4005

Mailing address

173 Mount Auburn St
Watertown, MA 02472-4005
Phone (617) 396-7434

Other practice location 1

160 Old Derby St Ste 457
Hingham, MA 02043-4062
Phone (781) 837-8833

Other practice location 2

115 Mill St
Belmont, MA 02478-1048
Phone (800) 333-0338

Other practice location 3

11 River St
Wellesley, MA 02481-2017
Phone (617) 396-7434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2349801MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Colony Care Inc CurrentSince Dec 1, 2024 Accepting new patients
Shore Pine Psychiatry, PLLC Psychiatric/Mental Health Current Accepting new patients

Locations

11 River St
Wellesley Hills, MA 02481
Phone (781) 237-7979

11 River St
Ste 1
Wellesley Hls, MA 02481
Phone (508) 695-7447

Organizations & group practices 2

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": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1861252835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 MOUNT AUBURN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724005",
            "telephone_number": "617-396-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 MOUNT AUBURN ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724005",
            "telephone_number": "617-396-7434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 Old Derby St Ste 457",
            "address_purpose": "LOCATION",
            "city": "Hingham",
            "state": "MA",
            "postal_code": "020434062",
            "country_code": "US",
            "telephone_number": "781-837-8833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Mill St",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "MA",
            "postal_code": "024781048",
            "country_code": "US",
            "telephone_number": "800-333-0338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 River St",
            "address_purpose": "LOCATION",
            "city": "Wellesley",
            "state": "MA",
            "postal_code": "024812017",
            "country_code": "US",
            "telephone_number": "617-396-7434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODDY",
        "first_name": "KATHRYN",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2349801",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2349801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

Verify at the official NPI Registry.