CARLY BERNSTEIN ROSE (PA-C) – Dermatology Physician, NPI 1194204701

CARLY BERNSTEIN ROSE (PA-C) is a healthcare provider. based in Wellesley, Massachusetts. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA6704 (MA). The NPI Number for CARLY BERNSTEIN ROSE (PA-C) is 1194204701

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
CARLY BERNSTEIN ROSE (PA-C)
NPI
1194204701
Phone
(774) 344-4046
Address
888 WORCESTER ST STE 95
Enumeration Date
14 August 2018
Last Update Date
22 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6319983495
Graduation Year
2018 (8 years ago)
PAC ID
5395098016
Group Practice PAC ID
8426412578
Professional Enrollment ID
I20181026001235
Address ID
MA021103036BO200XXSTXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:7State licenses:1Digital endpointsOther names

5,093 PHYSICIAN ASSISTANT in MA

Provider Addresses for CARLY BERNSTEIN ROSE (PA-C)

  • 888 WORCESTER ST STE 95

    WELLESLEY, MA 024823737

    Phone: (774) 344-4046

    Fax: (857) 999-3940

    Type: Mailing

  • 200 HIGH ST FL 5

    BOSTON, MA 021103036

    Phone: (617) 221-6909

    Fax: (617) 507-5639

    Type: Mailing

  • 28 EXETER ST APT 711

    BOSTON, MA 021164843

    Phone: (617) 959-1360

    Type: Mailing

  • Brigham and Women's Hospital, 75, Francis Street, Roxbury, Boston, Suffolk County, Massachusetts, 02115, United States

    BOSTON, MA 021156110

    Phone: (617) 732-5500

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-10-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20181026001235IPhysician AssistantMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02482)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426412578View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YMA

Reviews

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Frequently asked questions

What is CARLY BERNSTEIN ROSE (PA-C)'s NPI number?
CARLY BERNSTEIN ROSE (PA-C)'s NPI is 1194204701 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to CARLY BERNSTEIN ROSE (PA-C)?
You should see CARLY BERNSTEIN ROSE (PA-C) as active in CMS-hosted NPPES data.
What area of care is associated with CARLY BERNSTEIN ROSE (PA-C)?
CARLY BERNSTEIN ROSE (PA-C)'s record emphasizes Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where in Massachusetts is CARLY BERNSTEIN ROSE (PA-C) registered?
Use Wellesley, Massachusetts as the headline location for CARLY BERNSTEIN ROSE (PA-C) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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