Individual provider Active NPI

Travis Cory Caldarone

  • Psychiatric/Mental Health Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1740801299
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
092467-23 Issued in NH
Practice address
235 N Pearl St
Brockton, MA 02301-1794
Phone
(508) 427-3000
NPI assigned
May 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 130335 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 092467-23 NH Primary

Addresses

Primary practice location

235 N Pearl St
Brockton, MA 02301-1794

Mailing address

960 Massachusetts Ave Ste 2
Boston, MA 02118-2690
Phone (617) 414-5405

Other practice location 1

55 Fogg Rd
South Weymouth, MA 02190-2455
Phone (781) 624-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200817002433 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8820414261 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BMC Affiliated Physicians, Inc.Group PAC ID 9830133123, 543 clinicians

Practice addresses (Care Compare)

235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-3000

Hospital & facility affiliations

  • Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
092467-23NHMDPsychiatric/Mental Health Nurse Practitioner
130335MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2020 Accepting new patients
BMC Affiliated Physicians, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 22, 2020 Accepting new patients
South Suburban Gastroenterology, PC CurrentSince Mar 24, 2024 Accepting new patients
Weymouth Endoscopy, LLC PastSince Mar 24, 2024 Accepting new patients

Locations

138 Haverhill St
Andover, MA 01810
Phone (978) 296-2302

960 Massachusetts Ave
Ste 2
Boston, MA 02118

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

70 East St
Methuen, MA 01844
Phone (978) 682-1906

97 Libbey Park
Ste 300
Weymouth, MA 02189
Phone (781) 331-2922

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

1085 Main St
Weymouth, MA 02190
Phone (781) 331-2922

Interoperability endpoints

  • Direct secure messaging: tcaldarone97527@direct.bmc.masshiway.net

Organizations & group practices 5

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": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1740801299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE STE 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690",
            "telephone_number": "617-414-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "South Weymouth",
            "state": "MA",
            "postal_code": "021902455",
            "country_code": "US",
            "telephone_number": "781-624-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALDARONE",
        "first_name": "TRAVIS",
        "middle_name": "CORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "130335",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "092467-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.