CMS-1500 Box 24J / 33a • NPI
1184796617
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
364SP0809X (CMS 89)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Adult
Box 32 Service Location & ZIP+4
82 MARLBOROUGH ST, BOSTON, MA, 02116-2020
✓ 9-Digit EDI 837 ZIP+4 (02116-2020)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1184796617 (KATHLEEN MARIE ANDOLINA, RN, CS, PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1184796617 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | KATHLEEN MARIE ANDOLINA, RN, CS, PC |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Adult NUCC Code: 364SP0809X (Clinical Nurse Specialist, Psych/Mental Health, Adult) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 82 MARLBOROUGH ST, BOSTON, MA, 02116-2020 |
| Practice Telephone / Fax | Tel: (774) 469-0299 | Fax: (617) 250-8502 |
| Administrative Mailing Address | 11 STUART ST, MEDFIELD, MA, 02052-3136 |
| Enumeration & Last Sync | Enumerated: 2006-11-13 | CMS Record Updated: 2015-08-04 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (364SP0809X)
What Does Taxonomy Code 364SP0809X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SP0809X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Adult"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (KATHLEEN MARIE ANDOLINA, RN, CS, PC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
163WP0808X — Registered Nurse, Psych/Mental HealthPlain English: Licensed & Credentialed Registered Nurse, Psych/Mental Health | State: MA | License: 145820 | Primary: Secondary |
364SP0809X — Clinical Nurse Specialist, Psych/Mental Health, AdultPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health, Adult | State: MA | License: 145820 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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