Individual provider Active NPI

Doreen Karoll, MD

  • Developmental - Behavioral Pediatrics Physician
  • Waltham, MA
National Provider Identifier
1982609228
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
73765 Issued in MA
Practice address
32 South St
Suite 200
Waltham, MA 02453-3555
Phone
(781) 549-7377
Fax
(781) 780-5688
NPI assigned
Jun 14, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X 73765 MA Primary

Addresses

Primary practice location

32 South St
Suite 200
Waltham, MA 02453-3555

Mailing address

32 South St
Suite 200
Waltham, MA 02453-3555
Phone (781) 549-7377

Other identifiers 1

IdentifierTypeStateIssuer
3096718MedicaidMA

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73765MAMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doreen Karoll, MD Developmental - Behavioral Pediatrics Past Accepting new patients

Organizations & group practices 1

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1982609228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SOUTH ST",
            "address_2": "SUITE 200",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533555",
            "telephone_number": "781-549-7377",
            "fax_number": "781-780-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 SOUTH ST",
            "address_2": "SUITE 200",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533555",
            "telephone_number": "781-549-7377",
            "fax_number": "781-780-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAROLL",
        "first_name": "DOREEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-14",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "MA",
            "license": "73765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3096718",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.