Carmine Colarusso, D.M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

19642 Issued in MA

Practice address

2 Jungle Rd
Leominster, MA 01453

Phone

(978) 534-8300

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2022 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1730163320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JUNGLE RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014535208",
            "telephone_number": "978-534-8300",
            "fax_number": "978-840-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JUNGLE RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-534-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Jungle Rd",
            "address_purpose": "LOCATION",
            "city": "Leominster",
            "state": "MA",
            "postal_code": "01453",
            "country_code": "US",
            "telephone_number": "978-534-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "386 Elm St",
            "address_purpose": "LOCATION",
            "city": "Gardner",
            "state": "MA",
            "postal_code": "014403926",
            "country_code": "US",
            "telephone_number": "978-632-7270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLARUSSO",
        "first_name": "CARMINE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "19642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William John Coakley III, D.M.D.
• Timothy J Cobb
• Rosemary Coffie
• Jeffrey David Cohen, DMD
• Melissa Ann Coil, MS
• Nicholas Jacob Colello
• Dannielle G Collagan, LMT
• Jaclyn Collentro, PT, DPT
• Freda Collet
• Beth A Colombo, MD

• Specialist in Leominster, MA
• Providers in Leominster, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.