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CARLY ROSE CHARBONNEAU NP
NPI 1174222475
Nurse Practitioner - Pediatrics in Springfield, MA

Active since February 27, 2023PECOS Enrolled
759 CHESTNUT ST STE C3358, SPRINGFIELD, MA 01107(413) 794-2398(413) 794-1273 Get Directions Write a Review

NPPES record last updated: February 18, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Aug 5, 2024, Feb 27, 2023 (2 updates tracked since 2023).

About Carly Rose Charbonneau Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY ROSE CHARBONNEAU NP (NPI 1174222475) is an individual pediatrics provider in Springfield, Massachusetts, licensed in Massachusetts (RN2286438) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174222475
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameCARLY ROSE CHARBONNEAUCredential: NP
Location Address759 CHESTNUT ST STE C3358Springfield, MA 01107-1619
Mailing Address280 Chestnut St Fl 2Springfield, MA 01199-1001 · (413) 794-5700
Phone(413) 794-2398
Fax(413) 794-1273
Sole ProprietorNo
Enumeration DateFebruary 27, 2023
Last NPPES UpdateFebruary 18, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 18, 2026
✔ NPI 1174222475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MA · RN2286438
759 CHESTNUT ST STE C3358, Springfield, MA 01107
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carly Rose Charbonneau Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Carly Charbonneau reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Baystate Medical Practices, Inc
Same address
Emergency Medical Services
759 CHESTNUT ST
Springfield, MA 01199
  • Reassigned Medicare billing, Massachusetts enrollment
  • 1,537 clinicians in this Medicare group
NPI 1548205909 (413) 794-5700

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.70 typical visit price
range $58.86 – $177.36
Typical copayment $22.67 (range $14.71 – $44.34)
Most-billed visit code 99203
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GRACE WOLCOTT BROWN APRN
Nurse Practitioner (Family)
759 CHESTNUT ST STE C3358
SPRINGFIELD, MA 01107
Hampden County (413) 794-2398
SAMANTHA TAYLOR PENDLETON DO, MHA
Pediatrics
759 CHESTNUT ST STE C3358
SPRINGFIELD, MA 01107
Hampden County (413) 794-2398

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Charbonneau's NPI number?

The NPI number for Carly Charbonneau is 1174222475. It was assigned to this individual provider in the NPPES registry on February 27, 2023.

Where is Carly Charbonneau located?

Carly Charbonneau practices at 759 Chestnut St Ste C3358, Springfield, MA 01107. The listed phone number is (413) 794-2398.

What is Carly Charbonneau's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Carly Charbonneau enrolled in Medicare?

Yes. Carly Charbonneau is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Carly Charbonneau's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carly Charbonneau reassigns Medicare benefits to Baystate Medical Practices, Inc (Springfield, MA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carly Charbonneau's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Carly Charbonneau was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.