Individual provider Active NPI

Karen Carreiro, FNP-C

  • Procedural Dermatology Physician
  • Fall River, MA
National Provider Identifier
1578073128
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
RN285354 Issued in MA
Practice address
775 Davol St Ste 3
Fall River, MA 02720-1028
Phone
(508) 674-4000
Fax
(508) 674-8880
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN01710 RI
Procedural Dermatology Physician 207NS0135X RN285354 MA Primary

Addresses

Primary practice location

775 Davol St Ste 3
Fall River, MA 02720-1028

Mailing address

775 Davol St Ste 3
Fall River, MA 02720-1028
Phone (508) 674-4000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200806000449 MA Practitioner - Nurse Practitioner 9931441144 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agape of Fall River Dermatology Dermatology CurrentSince Jul 5, 2020 Accepting new patients
Agape Medical Spa and Weight Loss Center LLC Dermatology CurrentSince Jul 6, 2020 Accepting new patients

Locations

775 Davol St
Fall River, MA 02720
Phone (508) 674-4000

775 Davol St
Ste 3
Fall River, MA 02720
Phone (508) 674-4000

775 Davol St
Ste 300
Fall River, MA 02720
Phone (508) 674-4000

1526 Atwood Ave
Ste 220
Johnston, RI 02919
Phone (401) 396-2227

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.

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1578073128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 DAVOL ST STE 3",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201028",
            "telephone_number": "508-674-4000",
            "fax_number": "508-674-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 DAVOL ST STE 3",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201028",
            "telephone_number": "508-674-4000",
            "fax_number": "508-674-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARREIRO",
        "first_name": "KAREN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN01710",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MA",
            "license": "RN285354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.