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SOUTHEASTERN PSYCHIATRIC ASSOC
NPI 1891771267
Psychiatry & Neurology - Psychiatry in Randolph, MA

Active since December 19, 2005
1093 N MAIN ST, RANDOLPH, MA 02368(781) 963-7775(781) 963-7776 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southeastern Psychiatric Assoc NPPES

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

SOUTHEASTERN PSYCHIATRIC ASSOC (NPI 1891771267) is a healthcare organization registered as a psychiatry in Randolph, Massachusetts and active in the NPI registry since December 2005. The organization lists Dean Solomon, President, as its authorized official.

NPPES Registry Identity

NPI1891771267
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameSOUTHEASTERN PSYCHIATRIC ASSOC
Location Address1093 N MAIN STRandolph, MA 02368
Mailing Address1093 N Main StRandolph, MA 02368 · (781) 963-7775 · Fax (781) 963-7776
Phone(781) 963-7775
Fax(781) 963-7776
Organization SubpartNo
Authorized OfficialDean SolomonPresident · (781) 963-7775
Enumeration DateDecember 19, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1891771267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1093 N MAIN ST, Randolph, MA 02368
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southeastern Psychiatric Assoc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

15

Medicare enrollment records show 15 clinicians reassign Medicare billing to Southeastern Psychiatric Assoc, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 10 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Psychiatry7
Clinical Social Worker4
Nurse Practitioner3
Clinical Psychologist1

Clinicians, nearest first (15)

Harry Berg, LICSW
Clinical Social Worker
NPI 1922187822
1093 N MAIN ST
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Krishnaswamy Gajaraj, M.D.
Psychiatry
NPI 1962488395
1093 N MAIN ST
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Daniel Kane, LICSW
Clinical Social Worker
NPI 1588640585
1093 N MAIN ST
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Amy Kavadlo, LICSW
Clinical Social Worker
NPI 1629054002
1093 N MAIN ST
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Jessica Kolczewski, MSN, APRN
Nurse Practitioner
NPI 1740670124
1093 N. MAIN ST.
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Leonard Marcus, MD
Psychiatry
NPI 1730165119
1093 N MAIN ST
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Fiona Mudge, MD
Psychiatry
NPI 1417933888
1093 N MAIN ST
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Dean Solomon, MD
Psychiatry
NPI 1588641641
1093 N MAIN ST
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Gary Warstadt, MD
Psychiatry
NPI 1639155013
1093 N MAIN ST
Randolph, MA 02368
(781) 963-7775
✔ PECOS✔ Accepts MedicareSame address
Evelyn Hale, M.D.
Psychiatry
NPI 1548450687
100 MORSE STREET
Norwood, MA 02062
(781) 769-8700
✔ PECOS✔ Accepts Medicare7.4 mi
Linda Sheppard-Reece, PMHNP-BC
Nurse Practitioner
NPI 1023495538
20 WINTER ST
Pembroke, MA 02359
(781) 312-1393
✔ PECOS✔ Accepts Medicare16 mi
Alcina Corbett, RN
Nurse Practitioner
NPI 1114673647
235 WELLESLEY ST
Weston, MA 02493
(781) 768-7000
✔ PECOS✔ Accepts Medicare17 mi
Peter Erines, PH.D.
Clinical Psychologist
NPI 1972536563
63 FOUNTAIN ST STE 402
Framingham, MA 01702
(508) 872-4813
✔ PECOS✔ Accepts Medicare20 mi
Paul Caratazzola
Clinical Social Worker
NPI 1174006670
1 BUMPS POND ROAD
Plymouth, MA 02360
(508) 291-2441
✔ PECOS✔ Accepts Medicare30 mi
Jill Harrison, M.D.
Psychiatry
NPI 1518192293
1 BUMPS POND ROAD
Plymouth, MA 02360
(508) 291-2441
✔ PECOS✔ Accepts Medicare31 mi

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

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 Southeastern Psychiatric Assoc's NPI number?

The NPI number for Southeastern Psychiatric Assoc is 1891771267. It was assigned to this organization in the NPPES registry on December 19, 2005.

Where is Southeastern Psychiatric Assoc located?

Southeastern Psychiatric Assoc is located at 1093 N Main St, Randolph, MA 02368. The listed phone number is (781) 963-7775.

What is Southeastern Psychiatric Assoc's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Southeastern Psychiatric Assoc enrolled in Medicare?

Yes. Southeastern Psychiatric Assoc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southeastern Psychiatric Assoc?

According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 4 Medicare specialties reassign their Medicare billing to Southeastern Psychiatric Assoc. A 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 the clinician's services. The largest specialties are Psychiatry (7), Clinical Social Worker (4) and Nurse Practitioner (3). Of these, 9 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southeastern Psychiatric Assoc accept?

Health plans from Anthem Blue Cross and Blue Shield list Southeastern Psychiatric Assoc 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 Southeastern Psychiatric Assoc was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.