NPIMap

Individual provider Active NPI

Caitlin Polistena, MD

  • Surgery Physician
  • Chelmsford, MA
National Provider Identifier
1508284084
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
283456 Issued in MA
Practice address
21 Village Sqaure
Chelmsford, MA 01824
Phone
(978) 995-3292
NPI assigned
Apr 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME139118 FL
Surgery Physician 208600000X 283456 MA Primary

Addresses

Primary practice location

21 Village Sqaure
Chelmsford, MA 01824

Mailing address

35 United Dr Ste 102
West Bridgewater, MA 02379-1056
Phone (508) 238-8646

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address polistc@ccf.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200928001842 MA Practitioner - General Surgery 4880922590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precision Surgical Specialists of Lowell PCGroup PAC ID 0244535854, 4 clinicians

Practice addresses (Care Compare)

21 Village SQ
Chelmsford, MA 01824-2712
Phone (978) 995-3292

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME139118FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Surgical Specialists of Lowell PC Surgery CurrentSince Jul 24, 2020 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
LGH Medical Group, Inc. CurrentSince Feb 6, 2026 Accepting new patients
Precision Surgical Specialists of Lowell PC Surgery CurrentSince Aug 25, 2024 Accepting new patients
The Lowell General Hospital Past Accepting new patients
Lawrence General Hospital Past Accepting new patients
LGH Professional Services LLC Past Accepting new patients

Locations

21 Village Sq
Chelmsford, MA 01824
Phone (978) 995-3292

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

1 Hospital Dr
Lowell, MA 01852
Phone (978) 687-0156

35 United Dr
Ste 102
West Bridgewater, MA 02379

Interoperability endpoints

  • Direct secure messaging: cpolistena1344078@direct.ccf.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/248c4eac-ef54-410c-af1d-d3a135ccb339/
  • Direct secure messaging: cpolistena31634@tuftsmedicine.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/

Organizations & group practices 7

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 2

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": "1396396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1508284084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 UNITED DR STE 102",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023791056",
            "telephone_number": "508-238-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 VILLAGE SQAURE",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "01824",
            "telephone_number": "978-995-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISTENA",
        "first_name": "CAITLIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-02",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME139118",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "283456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "polistc@ccf.org",
            "affiliation": "N",
            "address_1": "2950 Cleveland Clinic Blvd",
            "city": "Weston",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333313609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chelmsford, MA

Sources for this page

Verify at the official NPI Registry.