Cassandra R Walcott, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

205296 Issued in MA

Practice address

1324 Belmont St Ste 105
Brockton, MA 02301-4435

Phone

(508) 427-6000

Fax

(508) 427-6010

NPI assigned

Oct 5, 2005

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 8

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: walcott.cassandra.pbroc@direct.partners.masshiway.net
• Direct secure messaging: cassandra.walcott.chp@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 and National Provider Directory roles.

• Pediatric Associates Inc. of Brockton

  • Pediatrics Physician
  • Brockton, MA
  • NPI 1649389552

  Pediatrics

  NPD
• Cedar Hill Pediatrics LLC

  • Pediatrics Physician
  • Brockton, MA
  • NPI 1508351784

  Pediatrics

  NPD (past)
• J Rako MD PC

  • Pediatrics Physician
  • Brockton, MA
  • NPI 1699756122

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1366439150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 BELMONT ST STE 105",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014435",
            "telephone_number": "508-427-6000",
            "fax_number": "508-427-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 BELMONT ST STE 105",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014435",
            "telephone_number": "508-427-6000",
            "fax_number": "508-427-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCOTT",
        "first_name": "CASSANDRA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "205296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "202245",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "30187",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3208273",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "60167",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "205296",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2329786",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J22392",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6101419001",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cassandra.Walcott.CHP@direct.partners.masshiway.net",
            "affiliation": "N",
            "address_1": "1324 Belmont St Ste 105",
            "city": "Brockton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023014435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bernard Waigi
• Marcia Waitzman, MD
• Susanne D Wakerly, RD,LDN
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Emily Waldron
• Ashley May Walecka, OD
• Walgreen Co
• Walgreen Eastern Co Inc
• Walgreen Eastern Co Inc

• All providers in Brockton, MA
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.