Individual provider Active NPI

Carolyn Liane Siegal, D.P.M.

  • Foot Surgery Podiatrist
  • Norwood, MA
National Provider Identifier
1851459093
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
2308 Issued in MA
Practice address
1177 Providence Highway
Norwood, MA 02062
Phone
(781) 278-5635
Fax
(781) 440-7585
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X E4248 CA
Foot Surgery Podiatrist 213ES0131X 2308 MA Primary

Addresses

Primary practice location

1177 Providence Highway
Norwood, MA 02062

Mailing address

1177 Providence Highway
Norwood, MA 02062
Phone (781) 278-5635

Other identifiers 3

IdentifierTypeStateIssuer
0729507MedicaidMA
E4248OtherCACA LICENSE #
2308OtherMAMA MEDICAL LICENSE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csiegaldpm24055@direct.atrius.masshiway.net

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070522000112 MA Practitioner - Podiatry 8022912559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

230 Worcester St
Wellesley, MA 02481-5420
Phone (781) 431-5200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue52
Removal of skin lesions48
Removal of nail tissue173
Removal or shaving of skin growth15
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2308MAMDOptometrist
E4248CAMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Sep 29, 2010 Accepting new patients
Atrius Health, Inc. Current Accepting new patients
Atrius Health, Inc. CurrentSince Sep 29, 2010 Accepting new patients
New England Podiatry Associates, P.C. Foot Surgery Past Accepting new patients
Atrius Health, Inc. Past Accepting new patients
Dorothy H. Lowe, M.D. a Medical Corporation Past Accepting new patients
Rubencio Quintana, M.D. Inc. PastSince Mar 6, 2012 Accepting new patients

Locations

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

230 Worcester St
Wellesley Hills, MA 02481
Phone (781) 431-5200

Interoperability endpoints

  • Direct secure messaging: csiegaldpm24055@direct.atrius.masshiway.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1851459093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 PROVIDENCE HIGHWAY",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "02062",
            "telephone_number": "781-278-5635",
            "fax_number": "781-440-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 PROVIDENCE HIGHWAY",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "02062",
            "telephone_number": "781-278-5635",
            "fax_number": "781-440-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGAL",
        "first_name": "CAROLYN",
        "middle_name": "LIANE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2021-03-19",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E4248",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MA",
            "license": "2308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0729507",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE #",
            "identifier": "E4248",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA MEDICAL LICENSE #",
            "identifier": "2308",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csiegaldpm24055@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "1177 Providence Highway",
            "city": "Norwood",
            "state": "MA",
            "country_code": "US",
            "postal_code": "02062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

Verify at the official NPI Registry.