Individual provider Active NPI

Keila Casillas Claudio, NP-C

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1679851711
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2298448 Issued in MA
Practice address
400 Shawmut Ave
Boston, MA 02118-2006
Phone
(617) 587-1900
Fax
(617) 587-1901
NPI assigned
Jul 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2298448 MA Primary
Registered Dietitian 133V00000X
Family Nurse Practitioner 363LF0000X 26NJ00675800 NJ

Addresses

Primary practice location

400 Shawmut Ave
Boston, MA 02118-2006

Mailing address

1601 Washington St
Boston, MA 02118-1951
Phone (617) 425-2000

Other practice location 1

1601 Washington St
Boston, MA 02118-1951
Phone (617) 587-1900

Other practice location 2

143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200

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
I20181008001071 MA Practitioner - Nurse Practitioner 4789855784 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Shore Medical Center, Inc.Group PAC ID 3678487444, 174 clinicians

Practice addresses (Care Compare)

143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2763MAMDPhysical Therapy Assistant
RN2298448MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhealth Corporation CurrentSince Feb 1, 2020 Accepting new patients
South Shore Medical Center, Inc. CurrentSince Jul 13, 2022 Accepting new patients
Coastal Medical Associates CurrentSince Aug 5, 2024 Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Feb 1, 2020 Accepting new patients

Locations

1601 Washington St
Boston, MA 02118
Phone (617) 425-2000

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

5 Tarkiln Rd
Kingston, MA 02364
Phone (781) 585-2200

143 Longwater Dr
Norwell, MA 02061
Phone (781) 792-4136

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

Organizations & group practices 4

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 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": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1679851711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181951",
            "telephone_number": "617-425-2000",
            "fax_number": "617-425-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SHAWMUT AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182006",
            "telephone_number": "617-587-1900",
            "fax_number": "617-587-1901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Washington St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021181951",
            "country_code": "US",
            "telephone_number": "617-587-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "143 Longwater Dr",
            "address_purpose": "LOCATION",
            "city": "Norwell",
            "state": "MA",
            "postal_code": "020611683",
            "country_code": "US",
            "telephone_number": "781-878-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASILLAS CLAUDIO",
        "first_name": "KEILA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-22",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2298448",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00675800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.