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DR. KEVIN JOSEPH STALEY M.D.
NPI 1679512065
Psychiatry & Neurology - Neurology with Special Qualifications in Child Neurology in Boston, MA

Active since June 04, 2006PECOS EnrolledAccepts Medicare Assignment
55 FRUIT STREET, WAC 708D, BOSTON, MA 02114(617) 643-0363(617) 643-0141 Get Directions Write a Review

NPPES record last updated: December 26, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Kevin Joseph Staley M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN JOSEPH STALEY M.D. (NPI 1679512065) is an individual neurology with special qualifications in child neurology provider in Boston, Massachusetts, licensed in Massachusetts (230011) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Diego School Of Medicine (1984).

NPPES Registry Identity

NPI1679512065
Entity TypeIndividualMale
Primary Taxonomy2084N0402X
Provider Legal NameDR. KEVIN JOSEPH STALEYCredential: M.D.
Location Address55 FRUIT STREET, WAC 708DBoston, MA 02114
Mailing Address3 Shipway PlCharlestown, MA 02129-4301 · (617) 643-0363 · Fax (617) 643-0141
Phone(617) 643-0363
Fax(617) 643-0141
Sole ProprietorNo
Medical School CMSUniversity Of California, San Diego School Of MedicineGraduated 1984
Enumeration DateJune 4, 2006
Last NPPES UpdateDecember 26, 2012
✔ NPI 1679512065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Neurology with Special Qualifications in Child NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0402X
License✔ Licensed in MA · 230011
Definition
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
55 FRUIT STREET, Boston, MA 02114
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Taro Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin Joseph Staley M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193723856
PECOS Enrollment IDI20061114000139
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kevin Staley reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The General Hospital Corporation
Same address
General Acute Care Hospital
55 FRUIT ST, BULFINCH 360
Boston, MA 02114
  • Reassigned Medicare billing, Massachusetts enrollment
  • 6,234 clinicians in this Medicare group
NPI 1023049236 (617) 726-2000
Massachusetts General Physicians Organization Inc
Same address
Dermatology
55 FRUIT ST, BUL 2
Boston, MA 02114
  • Reassigned Medicare billing, Massachusetts enrollment
  • 6,360 clinicians in this Medicare group
NPI 1801874573 (617) 724-0287

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KUI TOH GERARD LEONG M.D.
Internal Medicine (Cardiovascular Disease)
55 FRUIT STREET, MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114
Suffolk County (617) 726-8862
MS. JACQUELINE BANGO LICSW
Social Worker (Clinical)
55 FRUIT STREET, FOUNDERS BUILDING SUITE 880
BOSTON, MA 02114
Suffolk County (617) 643-8281
SARA ELIZABETH GROSSLEIN PA
Physician Assistant
55 FRUIT STREET, WHITE 1
BOSTON, MA 02114
Suffolk County (617) 724-4100
JEFFREY M ELLENBOGEN M.D.
Psychiatry & Neurology (Neurology)
55 FRUIT STREET, WANG 720 (NEUROLOGY)
BOSTON, MA 02114
Suffolk County (617) 724-7419
DR. NANCY LEE HARRIS MD
Pathology (Anatomic Pathology & Clinical Pathology)
55 FRUIT STREET, WRN 2 PATHOLOGY ASSOCIATES
BOSTON, MA 02114
Suffolk County (617) 726-5155
DR. STANLEY YANG SHAW MD PHD
Internal Medicine (Cardiovascular Disease)
55 FRUIT STREET, YAW 5 CARDIAC UNIT ASSOCIATES
BOSTON, MA 02114
Suffolk County (617) 724-6750
LEONARDO V RIELLA M.D., PHD
Internal Medicine
55 FRUIT STREET, WHITE 5
BOSTON, MA 02114
Suffolk County (617) 726-5050
SUSAN MAHER CRNA
Nurse Anesthetist, Certified Registered
55 FRUIT STREET, CLN 309 MGH ANESTHESIA ASSOCIATES
BOSTON, MA 02114
Suffolk County (617) 726-3030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin Staley's NPI number?

The NPI number for Kevin Staley is 1679512065. It was assigned to this individual provider in the NPPES registry on June 4, 2006.

Where is Kevin Staley located?

Kevin Staley practices at 55 Fruit Street Wac 708D, Boston, MA 02114. The listed phone number is (617) 643-0363.

What is Kevin Staley's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology with Special Qualifications in Child Neurology, with taxonomy code 2084N0402X.

Is Kevin Staley enrolled in Medicare?

Yes. Kevin Staley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kevin Staley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Staley reassigns Medicare benefits to 2 organizations: The General Hospital Corporation (Boston, MA) and Massachusetts General Physicians Organization Inc (Boston, MA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin Staley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Staley accept?

Health plans from Taro Health list Kevin Staley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kevin Staley was last updated on December 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.