Carl Leon Danielson III, MD FACS

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

76101 Issued in MA

Practice address

50 Rowe Street
Suite 400
Melrose, MA 02176

Phone

(781) 665-4462

Fax

(781) 620-1930

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 13

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Hallmark Health Medical Associates Inc

  • Family Medicine Physician
  • Medford, MA
  • NPI 1770563900

  Surgery

  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1366488736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 ROWE STREET",
            "address_2": "SUITE 400",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "02176",
            "telephone_number": "781-665-4462",
            "fax_number": "781-620-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 ROWE STREET",
            "address_2": "SUITE 400",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "02176",
            "telephone_number": "781-665-4462",
            "fax_number": "781-620-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "CARL",
        "middle_name": "LEON",
        "name_suffix": "III",
        "credential": "MD FACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "76101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH",
            "identifier": "3093719",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "459233",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PREFERRED TUFTS",
            "identifier": "076101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE",
            "identifier": "459233",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J12576",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLANS",
            "identifier": "076101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "8557",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3093719",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COST CARE",
            "identifier": "39271",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "99028701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0035205",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS ASSOCIATED H PLANS",
            "identifier": "076101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "PR12357520001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CVS Pharmacy Inc
• CVS Pharmacy Inc
• Melinda D'Ippolito, LICSW
• Monica D Dale
• Daniel N Giatrelis DMD PC
• Scott Allan Darragh, DC MPH
• David J. Cohen, M.D.
• David M. Wahl, MD
• Roger R Davies, SCD.
• Jesse Davis, D.C.

• Surgery Physician in Melrose, MA
• Providers in Melrose, MA by specialty
• Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.