Individual provider Active NPI

Carolyn J. Sporn I

  • Emergency Medicine Physician
  • Burlington, MA
National Provider Identifier
1386690451
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
253295 Issued in MA
Practice address
Lahey Hospital & Medical Center
41 Mall Road
Burlington, MA 01805-0001
Phone
(781) 744-8100
Fax
(781) 744-5213
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0058461 MD
Emergency Medicine Physician 207P00000X 253295 MA Primary

Addresses

Primary practice location

Lahey Hospital & Medical Center
41 Mall Road
Burlington, MA 01805-0001

Mailing address

Lahey Hospital & Medical Center
41 Mall Road
Burlington, MA 01805-0001
Phone (781) 744-8100

Other identifiers 1

IdentifierTypeStateIssuer
386060400MedicaidMD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130701000586 MA Practitioner - Emergency Medicine 0941496715 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc Current Accepting new patients
Hallmark Health Urgent Care Physicians LLC Emergency Medicine CurrentSince Nov 1, 2013 Accepting new patients
Lahey Clinic, Inc. CurrentSince Mar 25, 2019 Accepting new patients
Melrose Wakefield Emergency Physicians, Inc. Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Newton Wellesley Emergency Medicine Specialist, P .C. Emergency Medicine CurrentSince Feb 24, 2020 Accepting new patients
Silver Spring Emergency Physicians, P.C. Emergency Medicine Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

30 New Crossing Rd
Reading, MA 01867
Phone (781) 213-5150

Interoperability endpoints

  • Direct secure messaging: csporn119577@direct.bilh.masshiway.net
  • Direct secure messaging: csporn28945@tuftsmedicine.direct-ci.com

Organizations & group practices 6

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1386690451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAHEY HOSPITAL & MEDICAL CENTER",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8100",
            "fax_number": "781-744-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAHEY HOSPITAL & MEDICAL CENTER",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8100",
            "fax_number": "781-744-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORN",
        "first_name": "CAROLYN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0058461",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "253295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386060400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.