Individual provider Active NPI

Caitlin Mary Keenan Trilla

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1104229442
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2283366 Issued in MA
Practice address
398 Neponset Ave
Boston, MA 02122-3134
Phone
(617) 282-3200
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2283366 MA Primary

Addresses

Primary practice location

398 Neponset Ave
Boston, MA 02122-3134

Mailing address

770 Centre St
Jamaica Plain, MA 02130-2706
Phone (203) 856-7932

Other names 1

  • Caitlin Mary Keenan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141202000277 MA Practitioner - Nurse Practitioner 2961724935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Practice Group PCGroup PAC ID 5395717920, 16 clinicians

Practice addresses (Care Compare)

11 Water St
Suite 1a
Arlington, MA 02476-4814
Phone (781) 648-9700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2283366MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Group PC CurrentSince Aug 1, 2020 Accepting new patients
Harbor Health Services Inc CurrentSince Nov 17, 2014 Accepting new patients
Family Practice Group, P.C. Past Accepting new patients

Locations

11 Water St
Arlington, MA 02476

11 Water St
Ste 1A
Arlington, MA 02476
Phone (781) 648-9700

398 Neponset Ave
Dorchester, MA 02122
Phone (617) 282-3200

250 Mount Vernon St
Dorchester, MA 02125
Phone (617) 288-1140

1135 Morton St
Mattapan, MA 02126
Phone (617) 533-2300

Interoperability endpoints

  • Direct secure messaging: ctrilla252826@direct.bilh.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1104229442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 CENTRE ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302706",
            "telephone_number": "203-856-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 NEPONSET AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021223134",
            "telephone_number": "617-282-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRILLA",
        "first_name": "CAITLIN",
        "middle_name": "MARY KEENAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2283366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "KEENAN",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.