Individual provider Active NPI

Michele Decarlo

  • Certified Registered Nurse Anesthetist
  • New York, NY
National Provider Identifier
1619603313
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
721459 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-2323
NPI assigned
Jul 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 721459 NY Primary
Registered Nurse 163W00000X RN2341799 MA

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

47 Chapel St
Greenwich, CT 06831-5108

Other practice location 1

360 Huntington Ave
Boston, MA 02115-5005
Phone (617) 373-3124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231219002839 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638529506 Reassigns benefits to 1 organization
I20250328000672 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9638529506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Medical Group, Inc.Group PAC ID 3971987108, 140 clinicians

Practice addresses (Care Compare)

47 Middlesex Tpke
Burlington, MA 01803-4945
Phone (857) 282-8100

81 Highland Ave
Salem, MA 01970-2714
Phone (617) 726-4121

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

Merit-based Incentive Payment System (MIPS)

Final score
77.79 of 100Reported as group
Quality
80.63
Improvement activities
40
Cost
49.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
721459NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Anesthesiology Group Nurse Anesthetist, Certified Registered CurrentSince Nov 4, 2023 Accepting new patients
Mass General Brigham Medical Group, Inc. CurrentSince May 12, 2025 Accepting new patients

Locations

47 Middlesex Tpke
Burlington, MA 01803
Phone (857) 282-8100

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

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.

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": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1619603313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 CHAPEL ST",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Huntington Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155005",
            "country_code": "US",
            "telephone_number": "617-373-3124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECARLO",
        "first_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "721459",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2341799",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.