Individual provider Active NPI

Caroline P. Macintosh, CRNA

  • Certified Registered Nurse Anesthetist
  • Weymouth, MA
National Provider Identifier
1184865750
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2260671 Issued in MA
Practice address
163 Libbey Pkwy
Suite 301
Weymouth, MA 02189-3118
Phone
(781) 337-4224
Fax
(781) 335-0429
NPI assigned
Mar 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN2260671 MA Primary

Addresses

Primary practice location

163 Libbey Pkwy
Suite 301
Weymouth, MA 02189-3118

Mailing address

163 Libbey Pkwy
Suite 301
Weymouth, MA 02189-3118
Phone (781) 337-4224

Other names 1

  • Caroline H. Park Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091121000034 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709925282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Anesthesia Associates PLLCGroup PAC ID 0042675282, 29 clinicians
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

40 Allied Dr
Dedham, MA 02026-6146
Phone (617) 865-1110

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2260671MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Dec 28, 2024 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Dec 4, 2018 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients
South Shore Anesthesia Associates, Inc Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

40 Allied Dr
Dedham, MA 02026
Phone (617) 264-1100

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312848000000",
    "number": "1184865750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 LIBBEY PKWY",
            "address_2": "SUITE 301",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893118",
            "telephone_number": "781-337-4224",
            "fax_number": "781-335-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 LIBBEY PKWY",
            "address_2": "SUITE 301",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893118",
            "telephone_number": "781-337-4224",
            "fax_number": "781-335-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACINTOSH",
        "first_name": "CAROLINE",
        "middle_name": "P.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2011-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2260671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "PARK",
            "middle_name": "H.",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.