Individual provider Active NPI

Caroline Dudman

  • Family Nurse Practitioner
  • Stoneham, MA
National Provider Identifier
1194194126
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN188705 Issued in MA
Practice address
45 Fieldstone Dr
Stoneham, MA 02180-1932
Phone
(617) 301-2840
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN188705 MA Primary
Family Nurse Practitioner 363LF0000X 072593-23 NH

Addresses

Primary practice location

45 Fieldstone Dr
Stoneham, MA 02180-1932

Mailing address

45 Fieldstone Dr
Stoneham, MA 02180-1932
Phone (617) 301-2840

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
I20160316000245 MA Practitioner - Nurse Practitioner 4880990944 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN188705MAMDFamily Nurse Practitioner
072593-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women's Hospital Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Feb 1, 2021 Accepting new patients
LGH Professional Services LLC Past Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

Interoperability endpoints

  • Direct secure messaging: dudman.caroline.bwh@direct.partners.masshiway.net

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": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1194194126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FIELDSTONE DR",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801932",
            "telephone_number": "617-301-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 FIELDSTONE DR",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801932",
            "telephone_number": "617-301-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDMAN",
        "first_name": "CAROLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN188705",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "072593-23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.