Individual provider Active NPI

Karen G. Carrasquillo, O.D.

  • Corneal and Contact Management Optometrist
  • Needham, MA
National Provider Identifier
1902992217
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
4552 Issued in MA
Practice address
464 Hillside Ave
Suite 205
Needham, MA 02494-1227
Phone
(781) 726-7333
Fax
(781) 726-7311
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 4552 MA Primary

Addresses

Primary practice location

464 Hillside Ave
Suite 205
Needham, MA 02494-1227

Mailing address

464 Hillside Ave
Suite 205
Needham, MA 02494-1227
Phone (781) 726-7333

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
I20061025000484 MA Practitioner - Optometry 7517964091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Boston Foundation for Sight IncGroup PAC ID 7012977424, 6 clinicians

Practice addresses (Care Compare)

464 Hillside Ave
Suite 205
Needham, MA 02494-1228
Phone 7817267337139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
4552MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Boston Foundation for Sight, Inc. Corneal and Contact Management CurrentSince Feb 1, 2014 Accepting new patients
Boston Eye Associates, P.C. Past Accepting new patients

Locations

464 Hillside Ave
Ste 205
Needham Heights, MA 02494
Phone (781) 726-7337

Interoperability endpoints

  • Direct secure messaging: kcarrasquillo@bostonsight.direct.eyemdemr.com

Organizations & group practices 2

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902992217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 HILLSIDE AVE",
            "address_2": "SUITE 205",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024941227",
            "telephone_number": "781-726-7333",
            "fax_number": "781-726-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 HILLSIDE AVE",
            "address_2": "SUITE 205",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024941227",
            "telephone_number": "781-726-7333",
            "fax_number": "781-726-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO",
        "first_name": "KAREN",
        "middle_name": "G.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MA",
            "license": "4552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

Verify at the official NPI Registry.