Individual provider Active NPI

Caroline Eyvazzadeh, MD

  • Rheumatology Physician
  • Boston, MA
National Provider Identifier
1649376377
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
50399 Issued in MA
Practice address
150 S Huntington Ave
Boston, MA 02130-4817
Phone
(617) 232-9500
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 50399 MA Primary

Addresses

Primary practice location

150 S Huntington Ave
Boston, MA 02130-4817

Mailing address

152 Pelham Island Rd
Wayland, MA 01778-2514
Phone (508) 358-4322

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160629002074 MA Order and Referring Only - RheumatologyPractitioner - Internal MedicinePractitioner - Rheumatology 5395928816

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649376377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 PELHAM ISLAND RD",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "017782514",
            "telephone_number": "508-358-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "617-232-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYVAZZADEH",
        "first_name": "CAROLINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MA",
            "license": "50399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.