NPIMap

Individual provider Active NPI

Robert Jason Carrasquillo, M.D.

  • Urology Physician
  • Burlington, MA
National Provider Identifier
1518225580
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
251657 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-2114
Phone
(781) 744-8000
NPI assigned
Apr 27, 2012
Last updated
Aug 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME130867 FL
Urology Physician 208800000X 251657 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-2114

Mailing address

1150 NW 14TH St
Suite 309
Miami, FL 33136-2137
Phone (305) 243-6090

Other practice location 1

1150 NW 14th St Ste 309
Miami, FL 33136-2114
Phone (305) 243-6069

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
I20180717000169 MA Practitioner - Urology 8729210695 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251657MAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc CurrentSince Aug 1, 2022 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 29, 2018 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince May 29, 2018 Accepting new patients
Lahey Clinic, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince May 29, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Urology CurrentSince May 29, 2018 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince May 29, 2018 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Urology CurrentSince May 29, 2018 Accepting new patients

Locations

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

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

145 Rosemary St
Ste B
Needham Heights, MA 02494
Phone (781) 433-2110

100 West St
Needham Hgts, MA 02494
Phone (781) 234-6300

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1518225580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 NW 14TH ST",
            "address_2": "SUITE 309",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362137",
            "telephone_number": "305-243-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018052114",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 NW 14th St Ste 309",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331362114",
            "country_code": "US",
            "telephone_number": "305-243-6069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRASQUILLO",
        "first_name": "ROBERT",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-27",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME130867",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "251657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.