Katelyn Rose Carney, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN277452 Issued in MA

Practice address

950 Winter St Ste 3800
Waltham, MA 02451-1405

Phone

(781) 779-5172

NPI assigned

Jul 12, 2012

Last updated

Nov 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Katelyn Rose Derby Former name

Medicare fee-for-service enrollment

Enrolled in MA, NH2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mass General Brigham Medical Group Northern Massachusetts IncGroup PAC ID 3577467224, 817 clinicians

Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore Medical Center - Hospital, Salem, MA, CCN 220035

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carney.katelyn.pma@direct.partners.masshiway.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mass General Brigham Medical Group Northern Massachusetts Inc

  • Emergency Medicine Physician
  • Salem, MA
  • NPI 1588606123
  Medicare reassignment Care Compare group NPD (past)
• Mass General Brigham Community Physicians Inc.

  • Internal Medicine Physician
  • Haverhill, MA
  • NPI 1891112637
  Medicare reassignment Care Compare group
• Careathome Medical Practice (Ma), P.C.

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1477123321
  Medicare reassignment NPD
• Perfect Health PC

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1861815300
  Medicare reassignment NPD
• Community Care Health Network LLC

  dba Matrix Medical Network

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1619368842

  NH

  Medicare reassignment NPD
• Pentucket Medical Associates, LLC

  • Internal Medicine Physician
  • Haverhill, MA
  • NPI 1609872886
  NPD
• Five Star Medical Office PC

  • Internal Medicine Physician
  • Forest Hills, NY
  • NPI 1760731459
  NPD (past)

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

• North Shore Medical Center, Inc.

  dba Salem Hospital

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1326303629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 SHORE DR",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030791337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WINTER ST STE 3800",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511405",
            "telephone_number": "781-779-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "KATELYN",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN277452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110093599A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "DERBY",
            "middle_name": "ROSE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Mary Carey, ANP
• Elizabeth Ann Carlson, CF-SLP
• Ana Carmona, LMHC
• Kendra Carnevale, D.C.
• Jean M Carney, PT
• Christine Ann Carpenter, RNP
• Melanie Carrasco-Santos, LMHC
• Robb Carroll, PA-C
• Ronald Richard Caruso, PA-C
• Julie E Caruth, M.D.

• Nurse Practitioner in Waltham, MA
• Providers in Waltham, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.