NPIMap

Individual provider Active NPI

Caryn A Libbey, M.D.

  • Rheumatology Physician
  • Boston, MA
National Provider Identifier
1417934142
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
43031 Issued in MA
Practice address
725 Albany St
Shapiro 7, Suite B
Boston, MA 02118-2526
Phone
(617) 638-7460
Fax
(617) 638-5226
NPI assigned
Dec 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 43031 MA Primary

Addresses

Primary practice location

725 Albany St
Shapiro 7, Suite B
Boston, MA 02118-2526

Mailing address

850 Harrison Ave
Yacc BN-C7
Boston, MA 02118-4001
Phone (617) 414-5405

Other identifiers 2

IdentifierTypeStateIssuer
0130923MedicaidMA
8111-0208MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120320000277 MA Practitioner - RheumatologyPractitioner - Internal Medicine 9537329180 Reassigns benefits to 1 organization
I20180924002195 NH Practitioner - Rheumatology 9537329180 Practice locations: Nashua, NH

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Tufts University School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

19 Tyler St
Suite 205
Nashua, NH 03060-2951
Phone (603) 889-5690

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031
  • Southern NH Medical Center Hospital, Nashua, NH, CCN 300020
  • St Joseph Hospital Hospital, Nashua, NH, CCN 300011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Medical Foundation, Inc. Rheumatology CurrentSince Apr 11, 1997 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

850 Harrison Ave
#7
Boston, MA 02118
Phone (617) 638-6100

725 Albany St
Ste B
Boston, MA 02118
Phone (617) 638-7480

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: clibbey11041@direct.bmc.masshiway.net

Organizations & group practices 2

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 11

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1417934142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YACC BN-C7",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST",
            "address_2": "SHAPIRO 7, SUITE B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-638-7460",
            "fax_number": "617-638-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBBEY",
        "first_name": "CARYN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MA",
            "license": "43031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130923",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8111-0208",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.