Individual provider Active NPI

Carly Bernstein Rose, PA-C

  • Surgery Physician
  • Brookline, MA
National Provider Identifier
1194204701
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
PA6704 Issued in MA
Practice address
235 Cypress St Ste 210
Brookline, MA 02445-6777
Phone
(617) 383-6250
NPI assigned
Aug 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X PA6704 MA Primary

Addresses

Primary practice location

235 Cypress St Ste 210
Brookline, MA 02445-6777

Mailing address

235 Cypress St Ste 210
Brookline, MA 02445-6777
Phone (617) 383-6250

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
I20181026001235 MA Practitioner - Physician Assistant 5395098016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hadlock Center for Facial Plastic Surgery PCGroup PAC ID 8426412578, 3 clinicians

Practice addresses (Care Compare)

200 High St
FL 5
Boston, MA 02110-3036
Phone (631) 998-3495

Hospital & facility affiliations

  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA6704MAMDSurgery Physician

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.

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": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1194204701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 CYPRESS ST STE 210",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456777",
            "telephone_number": "617-383-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 CYPRESS ST STE 210",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456777",
            "telephone_number": "617-383-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CARLY",
        "middle_name": "BERNSTEIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "PA6704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.