Individual provider Active NPI

Carolina Escudero, MD

  • Pediatric Cardiology Physician
  • Boston, MA
National Provider Identifier
1407300858
Registry record updated Aug 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
266593 Issued in MA
Practice address
240 Heath St
PH 16
Boston, MA 02130-1149
Phone
(617) 712-8043
NPI assigned
Aug 14, 2016
Last updated
Aug 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 266593 MA Primary

Addresses

Primary practice location

240 Heath St
PH 16
Boston, MA 02130-1149

Mailing address

240 Heath St
PH 16
Boston, MA 02130-1149
Phone (617) 712-8043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
266593MAMDPediatric Cardiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1471132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471132800000",
    "number": "1407300858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 HEATH ST",
            "address_2": "PH 16",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021301149",
            "telephone_number": "617-712-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HEATH ST",
            "address_2": "PH 16",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021301149",
            "telephone_number": "617-712-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCUDERO",
        "first_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-14",
        "last_updated": "2016-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MA",
            "license": "266593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2016; 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.