Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Corey Caracciolo

Individual provider Physician Assistant · NPI 1063059566

Corey Caracciolo is a Physician Assistant in Worcester, Massachusetts. Qualified in 2020, 6 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
6
Licensed in
MA
In the registry since
2019
Specialties on file
3
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Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (508) 334-0605
Fax: (508) 856-5074
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 28 Dudley Rd, Oxford, MA 01540-2234 — (774) 276-2152

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA8113 (MA)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1063059566
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 3, 2019
Last updated in NPPESJune 29, 2021
Certification dateJune 29, 2021
Mailing addressPo Box 415348, Boston, MA 02241-5348

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Worcester