| Medoptions Of Massachusetts Llc | |
|
84 State St Suite 660 Boston MA 02109-2202 | |
| (410) 832-2279 | |
| (860) 510-0020 |
| Full Name | Medoptions Of Massachusetts Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 84 State St, Boston, Massachusetts |
| Authorized Official Name and Position | Donna Dooley (CFO) |
| Authorized Official Contact | 8003703651 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medoptions Of Massachusetts Llc 55 Hatchetts Hill Rd Old Lyme CT 06371-1534 Ph: (800) 370-3651 | Medoptions Of Massachusetts Llc 84 State St Suite 660 Boston MA 02109-2202 Ph: (410) 832-2279 |
| NPI Number | 1053527028 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/30/2016 |
| Medicare PECOS PAC ID | 2062512403 |
|---|---|
| Medicare Enrollment ID | O20070713000377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053527028 | NPI | - | NPPES |
| 7001000W10663 | Other | MA | BLUE CROSS BLUE SHIELD |
| 9793640 | Medicaid | MA | |
| DG1569 | Other | MA | PALMETO / RAILROAD MEDICARE |
| Provider Name | Bruce A Kaster |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1346281961 PECOS PAC ID: 8022026731 Enrollment ID: I20060322000359 |
| Provider Name | Miles A Tarter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659498103 PECOS PAC ID: 7315042751 Enrollment ID: I20070413000342 |
| Provider Name | Andrew Seth Rosenzweig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942203690 PECOS PAC ID: 9234043134 Enrollment ID: I20090217000533 |
| Provider Name | Thomas Tashjian |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912959602 PECOS PAC ID: 3072700822 Enrollment ID: I20101207000308 |
| Provider Name | Selin S Kepkep |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477791168 PECOS PAC ID: 2365613585 Enrollment ID: I20110920000668 |
| Provider Name | Virginia Ann Rockhill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528097383 PECOS PAC ID: 8426071002 Enrollment ID: I20121019000154 |
| Provider Name | Marisa Brava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225470586 PECOS PAC ID: 7719111632 Enrollment ID: I20131009000481 |
| Provider Name | Corey Baechel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003149972 PECOS PAC ID: 6800119843 Enrollment ID: I20141229000161 |
| Provider Name | Christopher S Naitza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396144283 PECOS PAC ID: 0648585463 Enrollment ID: I20150821014058 |
| Provider Name | Kathleen T Jamieson-gargano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083088033 PECOS PAC ID: 3779885744 Enrollment ID: I20160107001806 |
| Provider Name | Marie Natacha Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689043465 PECOS PAC ID: 9335438001 Enrollment ID: I20160519000695 |
| Provider Name | Debra Marie Mello-byrne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497127906 PECOS PAC ID: 2163717083 Enrollment ID: I20160817000324 |
| Provider Name | Kara N Lindemayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376099416 PECOS PAC ID: 2668750852 Enrollment ID: I20161021001684 |
| Provider Name | Megan L Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356888390 PECOS PAC ID: 8729354311 Enrollment ID: I20171026001376 |
| Provider Name | Stephany Gyasi |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1508369166 PECOS PAC ID: 1355603663 Enrollment ID: I20180327001198 |
| Provider Name | Erica Marie Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487125217 PECOS PAC ID: 8820334345 Enrollment ID: I20190103002845 |
| Provider Name | Angela S Faro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982240586 PECOS PAC ID: 2860820909 Enrollment ID: I20200324000405 |
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