Individual provider Active NPI

Caitlin M. Agreda, AU.D.

  • Audiologist
  • Worcester, MA
National Provider Identifier
1902286750
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
SP-1064-AU Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(088) 563-9965
Fax
(774) 442-5170
NPI assigned
Jun 8, 2015
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X SP-1064-AU MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other practice location 1

281 Lincoln St
Worcester, MA 01605-2138
Phone (508) 334-8726

Other names 1

  • Caitlin M. Cotter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP-1064-AUMAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Center, Inc. CurrentSince Aug 3, 2023 Accepting new patients
Umass Memorial Medical Center, Inc. CurrentSince Aug 3, 2023 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Dec 1, 2020 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Dec 1, 2020 Accepting new patients

Locations

281 Lincoln St
Worcester, MA 01605
Phone (508) 334-8015

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1902286750",
    "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"
        },
        {
            "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": "088-563-9965",
            "fax_number": "774-442-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "281 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052138",
            "country_code": "US",
            "telephone_number": "508-334-8726",
            "fax_number": "508-334-8751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGREDA",
        "first_name": "CAITLIN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "SP-1064-AU",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "COTTER",
            "middle_name": "M.",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.