Individual provider Active NPI

Christine Anna Corallino, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Boston, MA
National Provider Identifier
1366961310
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
2017009488 Issued in MA
Practice address
14 Foster Street
#3
Boston, MA 02109
Phone
(603) 867-1960
NPI assigned
Sep 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 2017009488 MA Primary

Addresses

Primary practice location

14 Foster Street
#3
Boston, MA 02109

Mailing address

14 Foster St Apt 3
Boston, MA 02109-5519
Phone (603) 867-1960

Other identifiers 1

IdentifierTypeStateIssuer
2017009488OtherMAANCC

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
I20180416000989 MA Practitioner - Nurse Practitioner 9133482615 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Digestive Health Specialists, P.C.Group PAC ID 7416911011, 14 clinicians

Practice addresses (Care Compare)

4 Meeting House Rd
Suite 6 8
Chelmsford, MA 01824-2766
Phone (978) 454-9811

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017009488MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Specialists, P.C. CurrentSince May 9, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Apr 11, 2018 Accepting new patients
The General Hospital Corporation CurrentSince Apr 11, 2018 Accepting new patients
Gastrointestinal Specialists, LLC CurrentSince May 26, 2019 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

189 Quincy St
Brockton, MA 02302
Phone (508) 588-6700

4 Meeting House Rd
Ste 68
Chelmsford, MA 01824
Phone (978) 454-9811

4 Meeting House Rd
Ste 6
Chelmsford, MA 01824
Phone (978) 454-9811

Interoperability endpoints

  • Direct secure messaging: christine.corallino@gastrohealth.eclinicaldirectplus.com
  • FHIR API: https://7dd4c9b2-8c33-42e8-9be4-1fef2411298a.gastro.prod.fhir.ema-api.com/fhir/r4/

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.

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": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366961310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FOSTER ST APT 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021095519",
            "telephone_number": "603-867-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 FOSTER STREET",
            "address_2": "#3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02109",
            "telephone_number": "603-867-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORALLINO",
        "first_name": "CHRISTINE",
        "middle_name": "ANNA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "2017009488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2017009488",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.