Individual provider Active NPI

Kathy G Niknejad, M.D.

  • Urology Physician
  • Wellesley, MA
National Provider Identifier
1861551087
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
157074 Issued in MA
Practice address
230 Worcester St
Urology Dept
Wellesley, MA 02481-5420
Phone
(781) 431-5255
Fax
(781) 431-5329
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 157074 MA Primary

Addresses

Primary practice location

230 Worcester St
Urology Dept
Wellesley, MA 02481-5420

Mailing address

230 Worcester St
Urology Dept
Wellesley, MA 02481-5420
Phone (781) 431-5255

Other identifiers 1

IdentifierTypeStateIssuer
3193632MedicaidMA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040806000562 MA Practitioner - Urology 4183696651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Harvard Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians
President and Fellows of Harvard CollegeGroup PAC ID 2062303894, 94 clinicians

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

75 Mount Auburn St
Cambridge, MA 02138-4960
Phone (617) 496-8700

Hospital & facility affiliations

  • Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
157074MAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
President & Fellows of Harvard College Current Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
President and Fellows of Harvard College CurrentSince Aug 8, 2023 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Sep 14, 2020 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

188 Longwood Ave
Boston, MA 02115
Phone (617) 432-1434

75 Mount Auburn St
Cambridge, MA 02138
Phone (617) 495-2042

75 Mount Auburn St
#H
Cambridge, MA 02138
Phone (617) 495-4414

1153 Centre St
#L1
Jamaica Plain, MA 02130

Interoperability endpoints

  • Direct secure messaging: niknejad.kathy.bwh@direct.partners.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1861551087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 WORCESTER ST",
            "address_2": "UROLOGY DEPT",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815420",
            "telephone_number": "781-431-5255",
            "fax_number": "781-431-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 WORCESTER ST",
            "address_2": "UROLOGY DEPT",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815420",
            "telephone_number": "781-431-5255",
            "fax_number": "781-431-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKNEJAD",
        "first_name": "KATHY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "157074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3193632",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.