Active NPI
Carlyssa Medwin, PHARMD
- Pharmacist
- East Boston, MA
National Provider Identifier
1093621492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH1003766
- Practice address
- 20 Maverick SQ
East Boston, MA 02128-2335 - Phone
- (617) 455-7784
- NPI assigned
- Aug 24, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH1003766 | MA | Primary |
Addresses
Primary practice location
20 Maverick SQ
East Boston, MA 02128-2335
Mailing address
20 Maverick SQ
East Boston, MA 02128-2335
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1093621492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 MAVERICK SQ",
"city": "EAST BOSTON",
"state": "MA",
"postal_code": "021282335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 MAVERICK SQ",
"city": "EAST BOSTON",
"state": "MA",
"postal_code": "021282335",
"telephone_number": "617-455-7784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDWIN",
"first_name": "CARLYSSA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-24",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH1003766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.