Individual provider Active NPI

Carolyn B Long, CRNA

  • Certified Registered Nurse Anesthetist
  • Boston, MA
National Provider Identifier
1578018388
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2283866 Issued in MA
Practice address
330 Brookline Ave
Beth Israel Deaconess Medical Center, Yamins 219
Boston, MA 02215-5400
Phone
(617) 667-3364
Fax
(617) 667-5013
NPI assigned
Aug 22, 2016
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2283866 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Beth Israel Deaconess Medical Center, Yamins 219
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Beth Israel Deaconess Medical Center, Yamins 219
Boston, MA 02215-5400
Phone (617) 667-3364

Other practice location 1

55 Fogg Rd
South Weymouth, MA 02190-2432
Phone (781) 624-8000

Other practice location 2

2 Pond Park Rd
Hingham, MA 02043-4347
Phone (781) 624-8352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170426000906 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577840727 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2283866MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Mar 8, 2017 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Current Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Mar 8, 2017 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jun 9, 2020 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jun 9, 2020 Accepting new patients
Coastal Medical Associates Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2024 Accepting new patients

Locations

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

330 Brookline Ave
#219
Boston, MA 02215
Phone (617) 667-3110

40 Allied Dr
Dedham, MA 02026
Phone (617) 264-1100

2 Pond Park Rd
Hingham, MA 02043
Phone (781) 337-5555

25 Highland Ave
Newburyport, MA 01950
Phone (978) 258-4734

125 Parker Hill Ave
Roxbury Xing, MA 02120
Phone (617) 264-1100

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Organizations & group practices 6

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 1

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": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1578018388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BETH ISRAEL DEACONESS MEDICAL CENTER, YAMINS 219",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-3364",
            "fax_number": "617-667-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BETH ISRAEL DEACONESS MEDICAL CENTER, YAMINS 219",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-3364",
            "fax_number": "617-667-5013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "South Weymouth",
            "state": "MA",
            "postal_code": "021902432",
            "country_code": "US",
            "telephone_number": "781-624-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Pond Park Rd",
            "address_purpose": "LOCATION",
            "city": "Hingham",
            "state": "MA",
            "postal_code": "020434347",
            "country_code": "US",
            "telephone_number": "781-624-8352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "CAROLYN",
        "middle_name": "B",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "2283866",
            "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 Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.