NPIMap

Organization Active NPI

Center for Brain Health PLLC

  • Psychiatry Physician
  • Brookline, MA
National Provider Identifier
1962928457
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
269936 Issued in MA
Legal business name
CENTER FOR BRAIN HEALTH PLLC
Practice address
1101 Beacon St Ste 8W
Brookline, MA 02446-5587
Phone
(617) 855-7288
Fax
(860) 783-5590
NPI assigned
Aug 17, 2017
Last updated
Jan 7, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
DIGNITY WEIGHT CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Omar Haque, MD, PHDNPI 1528406196
Title
Owner
Phone
(617) 855-7288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 269936 MA Primary
Obesity Medicine (Psychiatry & Neurology) Physician 2084B0002X NU
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X NU

Addresses

Primary practice location

1101 Beacon St Ste 8W
Brookline, MA 02446-5587

Mailing address

1101 Beacon St Ste 8W
Brookline, MA 02446-5587
Phone (617) 855-7288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171031001142 MA Part B Supplier - Clinic/Group Practice 8527334911 Receives reassigned benefits from 17 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brookline, MA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Center for Brain Health PLLC

Locations

1101 Beacon St
Ste 1W
Brookline, MA 02446
Phone (617) 731-2390

1101 Beacon St
Ste 8W
Brookline, MA 02446
Phone (617) 277-5510

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1962928457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BEACON ST STE 8W",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465587",
            "telephone_number": "617-855-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BEACON ST STE 8W",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465587",
            "telephone_number": "617-855-7288",
            "fax_number": "860-783-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR BRAIN HEALTH PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIGNITY WEIGHT CENTER",
        "enumeration_date": "2017-08-17",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "HAQUE",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-855-7288",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "269936",
            "primary": true
        },
        {
            "code": "2084B0002X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.