Individual provider Active NPI

Laurence H Brinckerhoff, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Boston, MA
National Provider Identifier
1013943679
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
223013 Issued in MA
Practice address
830 Harrison Ave FL 3
Moakley BLDG.
Boston, MA 02118
Phone
(617) 638-5600
Fax
(617) 638-7228
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 223013 MA Primary

Addresses

Primary practice location

830 Harrison Ave FL 3
Moakley BLDG.
Boston, MA 02118

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other practice location 1

732 Harrison Ave., 3rd Floor West
Preston Bldg.
Boston, MA 02118-2309
Phone (617) 388-4886

Other identifiers 2

IdentifierTypeStateIssuer
110039565AMedicaidMA
3111080MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040928001031 MA Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 3870562622 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University General Surgical Associates, Inc.-QMC CurrentSince Dec 23, 2021 Accepting new patients
Pratt Surgical Associates Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Sep 1, 2004 Accepting new patients
Boston University General Surgical Associates, Inc. CurrentSince Dec 23, 2021 Accepting new patients
LGH Professional Services LLC Past Accepting new patients
Boston Medical Center Corporation Past Accepting new patients

Locations

732 Harrison Ave
Fl 3
Boston, MA 02118
Phone (617) 638-5350

800 Washington St
#7105
Boston, MA 02111
Phone (617) 636-2395

732 Harrison Ave
Fl 5
Boston, MA 02118
Phone (617) 414-6840

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

960 Massachusetts Ave
Ste 2
Boston, MA 02118

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

750 Washington St
#276
Boston, MA 02111
Phone (617) 636-5025

720 Harrison Ave
Ste 700
Boston, MA 02118
Phone (617) 638-8488

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

41 Montvale Ave
Stoneham, MA 02180
Phone (781) 224-5806

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.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1013943679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE FL 3",
            "address_2": "MOAKLEY BLDG.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-5600",
            "fax_number": "617-638-7228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 Harrison Ave., 3rd Floor West",
            "address_2": "Preston Bldg.",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182309",
            "country_code": "US",
            "telephone_number": "617-388-4886",
            "fax_number": "617-638-8469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRINCKERHOFF",
        "first_name": "LAURENCE",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MA",
            "license": "223013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110039565A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3111080",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.