| Karsten Dirk Kueppenbender, MD, CGP | |
|
1130 Massachusetts Ave, Third Floor, Cambridge, MA 02138-5204 | |
| (617) 855-3966 | |
| (617) 441-8303 |
| Full Name | Karsten Dirk Kueppenbender |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 1130 Massachusetts Ave, Cambridge, Massachusetts |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265468292 | NPI | - | NPPES |
| J29279 | Other | MA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 219749 (Massachusetts) | Secondary |
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | 219749 (Massachusetts) | Primary |
| Entity Name | The Mclean Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114979580 PECOS PAC ID: 9436040961 Enrollment ID: O20040323001228 |
| Mailing Address | Practice Location Address |
|---|---|
| Karsten Dirk Kueppenbender, MD, CGP 1130 Massachusetts Ave, Third Floor, Cambridge, MA 02138-5204 Ph: (617) 855-3966 | Karsten Dirk Kueppenbender, MD, CGP 1130 Massachusetts Ave, Third Floor, Cambridge, MA 02138-5204 Ph: (617) 855-3966 |
Lauren Morris, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 77 Massachusetts Ave # E23-368, Cambridge, MA 02139 Phone: 617-253-2916 Fax: 877-932-6537 | |
Omayra Nieves, Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 30 Cambridgepark Dr Apt 6115, Cambridge, MA 02140 Phone: 617-877-5797 | |
Stella J Bae, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 49 Hancock St, Cambridge, MA 02139 Phone: 617-566-1055 | |
Dr. Peter F Wohlauer, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1105 Massachusetts Ave, Suite 2c, Cambridge, MA 02138 Phone: 617-491-2301 | |
Dr. Daniel A Brenner, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 6 Bigelow St, Cambridge, MA 02139 Phone: 617-661-1856 | |
Dr. Priyantha Herath, MD PHD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 675 W Kendall St, Cambridge, MA 02142 Phone: 202-997-0390 | |
Irina Angel, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1611 Cambridge St, Cambridge, MA 02138 Phone: 617-661-5515 Fax: 617-661-5182 |