Active NPI
Kathleen Shahrokhi, PHD
- Clinical Neuropsychologist
- Stoneham, MA
National Provider Identifier
1992850549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 3812
- Practice address
- 3 Woodland Rd Ste 200
Stoneham, MA 02180-1710 - Phone
- (781) 662-9001
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 3812 | MA | Primary |
Addresses
Primary practice location
3 Woodland Rd Ste 200
Stoneham, MA 02180-1710
Mailing address
16 Grove St
Medford, MA 02155
Phone (781) 483-2113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0524409 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5812 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fereydoun Shahrokhi, M.D. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Neurology Physician
- Stoneham, MA
- NPI 1912223975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469750400000",
"number": "1992850549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 GROVE ST",
"city": "MEDFORD",
"state": "MA",
"postal_code": "02155",
"telephone_number": "781-483-2113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 WOODLAND RD STE 200",
"city": "STONEHAM",
"state": "MA",
"postal_code": "021801710",
"telephone_number": "781-662-9001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAHROKHI",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2016-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "3812",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0524409",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stoneham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.