NPIMap

Individual provider Active NPI

Hormuzdiyar Henry Dasenbrock, MD

  • Neurological Surgery Physician
  • Boston, MA
National Provider Identifier
1013155688
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
266595 Issued in MA
Practice address
725 Albany Street
Shapiro 7, Suite C
Boston, MA 02118
Phone
(617) 638-8992
NPI assigned
Feb 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 266595 MA Primary

Addresses

Primary practice location

725 Albany Street
Shapiro 7, Suite C
Boston, MA 02118

Mailing address

720 Harrison Ave # Dob503
Boston, MA 02118-2371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190710000504 MA Practitioner - Neurosurgery 2860618089 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Johns Hopkins University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boston University Neurosurgical Associates IncGroup PAC ID 7618876798, 11 clinicians

Practice addresses (Care Compare)

725 Albany St
Suite 7C
Boston, MA 02118-3549
Phone (617) 638-8992

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031
  • Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111
  • Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Aug 15, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Aug 15, 2019 Accepting new patients
Boston University Neurosurgical Associates, Inc. Neurological Surgery CurrentSince Aug 15, 2019 Accepting new patients
Boston Medical Center Corporation Past Accepting new patients

Locations

725 Albany St
Ste 7C
Boston, MA 02118
Phone (617) 638-8992

725 Albany St
Ste C
Boston, MA 02118
Phone (617) 638-8992

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: hdasenbrock118539@direct.bmc.masshiway.net

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1013155688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE # DOB503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY STREET",
            "address_2": "SHAPIRO 7, SUITE C",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DASENBROCK",
        "first_name": "HORMUZDIYAR",
        "middle_name": "HENRY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MA",
            "license": "266595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.