NPIMap

Organization Active NPI

Caritas St Elizabeth's Medical Center-Psychiatry

  • Psychiatric Hospital Unit
  • Boston, MA
National Provider Identifier
1902974884
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
CARITAS ST ELIZABETH'S MEDICAL CENTER-PSYCHIATRY
Practice address
736 Cambridge St
Boston, MA 02135-2907
Phone
(617) 562-5460
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miles Converdale
Title
Authorized Officer
Phone
(617) 789-5173

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

736 Cambridge St
Boston, MA 02135-2907

Mailing address

77 Warren Street-Provider Enrollment Dept
Brighton, MA 02135
Phone (617) 562-5482

Other identifiers 1

IdentifierTypeStateIssuer
1201719MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Steward St Elizabeths Medical Center of Boston Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902974884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN STREET-PROVIDER ENROLLMENT DEPT",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-562-5482",
            "fax_number": "617-562-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-562-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARITAS ST ELIZABETH'S MEDICAL CENTER-PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONVERDALE",
        "authorized_official_first_name": "MILES",
        "authorized_official_title_or_position": "AUTHORIZED OFFICER",
        "authorized_official_telephone_number": "617-789-5173"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1201719",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.