Individual provider Active NPI

Caitlin Johnson Pasquale, N.P.

  • Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1821420951
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
284080 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3550
Fax
(774) 442-6715
NPI assigned
Jul 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 284080 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

275 Nichols Rd
Fitchburg, MA 01420-1919
Phone (978) 343-5048

Other identifiers 1

IdentifierTypeStateIssuer
110118890AMedicaidMA

Other names 1

  • Caitlin Johnson Rice Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cpasquale24823@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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
I20131129000020 MA Practitioner - Nurse Practitioner 9739315441 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Massachusetts Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
284080MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Nurse Practitioner CurrentSince Nov 28, 2016 Accepting new patients
Hallmark Health System Inc CurrentSince Sep 20, 2013 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Nov 28, 2016 Accepting new patients
Melrosewakefield Healthcare, Inc. CurrentSince Sep 20, 2013 Accepting new patients
Reliant Medical Group, Inc CurrentSince May 10, 2021 Accepting new patients
Melrosewakefield Healthcare, Inc. Current Accepting new patients

Locations

275 Nichols Rd
Fitchburg, MA 01420
Phone (978) 343-5048

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

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

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

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: cpasquale24823@umassmemorial.direct-ci.com

Organizations & group practices 6

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 3

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": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1821420951",
    "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": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3550",
            "fax_number": "774-442-6715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Nichols Rd",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "MA",
            "postal_code": "014201919",
            "country_code": "US",
            "telephone_number": "978-343-5048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASQUALE",
        "first_name": "CAITLIN",
        "middle_name": "JOHNSON",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "284080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110118890A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpasquale24823@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "RICE",
            "middle_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.