Individual provider Active NPI

Shuchi Khosla, MD

  • Psychiatry Physician
  • Boston, MA
National Provider Identifier
1861987778
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
292209 Issued in MA
Practice address
80 Fenwood Rd
Boston, MA 02115-6120
Phone
(617) 732-5056
Fax
(617) 738-1275
NPI assigned
Jun 25, 2018
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301114889 MI
Psychiatry Physician 2084P0800X 292209 MA Primary

Addresses

Primary practice location

80 Fenwood Rd
Boston, MA 02115-6120

Mailing address

80 Fenwood Rd
Boston, MA 02115-6120

Other identifiers 1

IdentifierTypeStateIssuer
292209OtherMASTATE LICENSE

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
I20230308001454 MA Practitioner - Psychiatry 5294115572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-2551

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301114889MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Jan 1, 2023 Accepting new patients
Brigham and Women's Hospital Current Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Jun 24, 2023 Accepting new patients
North Shore Medical Center, Inc. Current Accepting new patients

Locations

60 Fenwood Rd
Boston, MA 02115
Phone (617) 732-5056

75 Francis St
Boston, MA 02115

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

254 2nd Ave
Ste 100
Needham Heights, MA 02494
Phone (781) 416-8413

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: khosla.shuchi.bwh@direct.partners.masshiway.net
  • Direct secure messaging: khosla.shuchi.nsmc@direct.partners.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1861987778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 FENWOOD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 FENWOOD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156120",
            "telephone_number": "617-732-5056",
            "fax_number": "617-738-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSLA",
        "first_name": "SHUCHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301114889",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "292209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "292209",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.