Susan Carroll, RD is a medicare enrolled "Dietitian, Registered" provider in West Boylston, Massachusetts. Her current practice location is
360 W Boylston St Rm 107, West Boylston, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(508) 854-1380.
Susan Carroll is licensed to practice in Massachusetts (license number 217) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1497810600.
Healthcare Provider's Profile
| Full Name | Susan Carroll |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 360 W Boylston St Rm 107, West Boylston, Massachusetts |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1497810600
- Provider Enumeration Date: 12/27/2006
- Last Update Date: 12/27/2023
Medicare PECOS Information:
- PECOS PAC ID: 9931132552
- Enrollment ID: I20050914000974
Medical Identifiers
Medical identifiers for Susan Carroll such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1497810600 | NPI | - | NPPES |
| LD0181 | Other | MA | BCBS OF MA |
| AA51160 | Other | MA | HARVARD PILGRIM |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 217 (Massachusetts) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Susan Carroll allows following entities to bill medicare on her behalf.
| Provider Name | Mt Auburn Professional Services |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1992750996
PECOS PAC ID: 6103725031
Enrollment ID: O20040527001374 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Susan Carroll is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Susan Carroll, RD
372 Meridian St,
Boston, MA 02128-5123
Ph: (617) 398-7752 | Susan Carroll, RD
360 W Boylston St Rm 107,
West Boylston, MA 01583-2370
Ph: (508) 854-1380 |
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