Kathleen M Caruso, PA

Individual provider Active NPI Physician Assistant · Newton Centre, MA

NPI 1023081981 · NPPES record last updated May 6, 2015

Key facts

NPI
1023081981
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
33 (MA)
Practice address
1400 Centre Street
Suite 203
Newton Centre, MA 02459
Phone
(617) 244-9929
Fax
(617) 244-9935
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
33MAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Newton Centre Kids, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 33 MA Yes
Medical Physician Assistant 363AM0700X 33 MA

Addresses

Primary practice location

1400 Centre Street
Suite 203
Newton Centre, MA 02459

Mailing address

1400 Centre Street
Suite 203
Newton Centre, MA 02459
Phone (617) 244-9929

Other providers in Newton Centre, MA

All providers in Newton Centre, MA · Physician Assistant in Massachusetts

Sources for this page

Verify at the official NPI Registry.