Individual provider Active NPI

Daniel Carlucci, M.D.

  • Cardiovascular Disease Physician
  • Marlborough, MA
National Provider Identifier
1700076882
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
73472 Issued in MA
Practice address
159 Union St
Suite 103
Marlborough, MA 01752-1274
Phone
(508) 624-9687
Fax
(508) 739-1538
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 73472 MA Primary

Addresses

Primary practice location

159 Union St
Suite 103
Marlborough, MA 01752-1274

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (508) 334-1000

Other identifiers 5

IdentifierTypeStateIssuer
21661OtherMAFALLON
P00071262OtherMARR MEDICARE
3563OtherMAHARVARD PILGRIM HEALTH CA
3069958MedicaidMA
J10493OtherMABLUE CROSS & BLUE SHIELD

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
I20050214000967 MA Practitioner - Cardiovascular Disease (Cardiology) 9436048972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Massachusetts Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Cardiovascular Disease CurrentSince Dec 22, 2014 Accepting new patients

Locations

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

123 Summer St
Ste 290N
Worcester, MA 01608
Phone (508) 368-3130

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Interoperability endpoints

  • Direct secure messaging: daniel.carlucci.npi1700076882.reliant@direct.optumcare.masshiway.net

Organizations & group practices 1

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1700076882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "508-334-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 UNION ST",
            "address_2": "SUITE 103",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017521274",
            "telephone_number": "508-624-9687",
            "fax_number": "508-739-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLUCCI",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "73472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "21661",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00071262",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH CA",
            "identifier": "3563",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069958",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "J10493",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.