Individual provider Active NPI

Erin Carroll

  • Pediatrics Physician
  • Somerville, MA
National Provider Identifier
1457939654
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1018243 Issued in MA
Practice address
236 Highland Ave Ste 1
Somerville, MA 02143-1495
Phone
(617) 591-4440
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1018243 MA Primary

Addresses

Primary practice location

236 Highland Ave Ste 1
Somerville, MA 02143-1495

Mailing address

257 North Rd
Sudbury, MA 01776-1109
Phone (508) 737-4376

Other practice location 1

1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 665-1552

Other practice location 2

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-3276

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
I20240814003270 MA Practitioner - Pediatric Medicine 0648670364 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1018243MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission Current Accepting new patients
Cambridge Public Health Commission CurrentSince Sep 9, 2024 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

236 Highland Ave
Ste 1
Somerville, MA 02143
Phone (617) 591-4440

Interoperability endpoints

  • Direct secure messaging: ecarroll111737@direct.challiance.masshiway.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1457939654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 NORTH RD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761109",
            "telephone_number": "508-737-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 HIGHLAND AVE STE 1",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021431495",
            "telephone_number": "617-591-4440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1493 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021391047",
            "country_code": "US",
            "telephone_number": "617-665-1552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Brookline Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "022155400",
            "country_code": "US",
            "telephone_number": "617-667-3276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "ERIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "1018243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.