Individual provider Active NPI

Carolyn Camille McGregor, NP

  • Women's Health Nurse Practitioner
  • East Boston, MA
National Provider Identifier
1932395530
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
202000082NP-PP Issued in OR
Practice address
10 Gove St
East Boston, MA 02128-1920
Phone
(617) 569-5800
Fax
(617) 568-4780
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 202000082NP-PP OR Primary

Addresses

Primary practice location

10 Gove St
East Boston, MA 02128-1920

Mailing address

590 Country Club Pkwy
Ste a
Eugene, OR 97401-6025
Phone (617) 569-5800

Other identifiers 1

IdentifierTypeStateIssuer
0715948MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20201125002176 OR Practitioner - Nurse Practitioner 1254428204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care PCGroup PAC ID 8820986458, 38 clinicians

Practice addresses (Care Compare)

590 Country Club Pkwy
Suite a
Eugene, OR 97401-6025
Phone (541) 683-1559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Womens Care, PC CurrentSince Nov 2, 2020 Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. Past Accepting new patients

Locations

590 Country Club Pkwy
Ste A
Eugene, OR 97401
Phone (541) 683-1559

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": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1932395530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 COUNTRY CLUB PKWY",
            "address_2": "STE A",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016025",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 GOVE ST",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281920",
            "telephone_number": "617-569-5800",
            "fax_number": "617-568-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGREGOR",
        "first_name": "CAROLYN",
        "middle_name": "CAMILLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "202000082NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0715948",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Boston, MA

Sources for this page

Verify at the official NPI Registry.