Individual provider Active NPI

Caroline Rose Banevicius

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1679397475
Registry record updated Nov 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
158 Calumet St Apt 1
Boston, MA 02120-3594
Phone
(860) 819-6946
NPI assigned
Nov 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

158 Calumet St Apt 1
Boston, MA 02120-3594

Mailing address

158 Calumet St Apt 1
Boston, MA 02120-3594
Phone (860) 819-6946

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
I20260623001523 MA Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 8224501135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1731110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1679397475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 CALUMET ST APT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021203594",
            "telephone_number": "860-819-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 CALUMET ST APT 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021203594",
            "telephone_number": "860-819-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANEVICIUS",
        "first_name": "CAROLINE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-09",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.