Coralli R So, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

152261 Issued in MA

Practice address

585 Lebanon St
Radiology Department
Melrose, MA 02176-3225

Phone

(781) 979-3120

Fax

(781) 979-3994

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Diagnostic Radiology

Education

Boston University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Merrimack Radiology-Cra LLCGroup PAC ID 8426287269, 60 clinicians

MW Radiology-Cra LLCGroup PAC ID 6406270040, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Melrosewakefield Healthcare Hospital, Melrose, MA, CCN 220070
• Lowell General Hospital Hospital, Lowell, MA, CCN 220063
• Tufts Medical Center Hospital, Boston, MA, CCN 220116

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Merrimack Radiology-Cra LLC

  • Diagnostic Radiology Physician
  • Lowell, MA
  • NPI 1275871154
  Medicare reassignment Care Compare group NPD
• MW Radiology-Cra LLC

  • Diagnostic Radiology Physician
  • Melrose, MA
  • NPI 1114555398
  Medicare reassignment Care Compare group NPD
• LGH Professional Services LLC

  • Internal Medicine Physician
  • Lowell, MA
  • NPI 1417485541
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Melrosewakefield Healthcare, Inc.

  • General Acute Care Hospital
  • Medford, MA
  • NPI 1841290467
  Care Compare affiliation
• The Lowell General Hospital

  • General Acute Care Hospital
  • Lowell, MA
  • NPI 1407804669
  Care Compare affiliation
• Tufts Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  Care Compare affiliation

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1801830153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 W NEWTON ST",
            "address_2": "APARTMENT #3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021166405",
            "telephone_number": "781-979-3120",
            "fax_number": "781-979-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763225",
            "telephone_number": "781-979-3120",
            "fax_number": "781-979-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "CORALLI",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "152261",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": "152261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0196321",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Partha S Sinha, M.D., PH.D.
• Krystina Marie Smith-Claros, RN
• Kimberly Ann Smith-McCue, LICSW
• Erica Susan Smith
• Merry Robin Snyder-Drummond, CD(DONA), IBCLC
• Solomon & Wright Associates PC
• David Philip Solomon, DMD
• Frederick L Solomon, D.M.D
• Jared David Solomon, D.M.D
• Joseph Walter Solomon, DMD

• Vascular & Interventional Radiology Physician in Melrose, MA
• Providers in Melrose, MA by specialty
• Vascular & Interventional Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.
• 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.