Individual provider Active NPI

Eugene Yoshio Fukudome, MD

  • Plastic Surgery Physician
  • Boston, MA
National Provider Identifier
1083740401
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
235136 Issued in MA
Practice address
Massachusetts General Hospital
55 Fruit Street, Wacc 435
Boston, MA 02114
Phone
(617) 726-2066
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 235136 MA Primary

Addresses

Primary practice location

Massachusetts General Hospital
55 Fruit Street, Wacc 435
Boston, MA 02114

Mailing address

Massachusetts General Hospital
55 Fruit Street, Wacc 435
Boston, MA 02114
Phone (617) 726-2066

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
I20161018002885 MA Practitioner - General SurgeryPractitioner - Plastic and Reconstructive Surgery 3971766510 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Plastic and Reconstructive Surgery
Education
Warren Alpert Medical School of Brown University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr IncGroup PAC ID 4486567104, shared by 12 NPIs, 1,693 clinicians

Practice addresses (Care Compare)

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 667-7000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Plastic Surgery CurrentSince Sep 1, 2016 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2016 Accepting new patients
Atrius Health, Inc. CurrentSince Nov 1, 2016 Accepting new patients
Atrius Health, Inc. CurrentSince Nov 1, 2016 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Sep 1, 2016 Accepting new patients
Signature Healthcare Medical Group Inc CurrentSince Jan 7, 2018 Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

178 Quincy Ave
Brockton, MA 02302
Phone (508) 584-8580

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: efukudomemd180894@direct.atrius.masshiway.net
  • Direct secure messaging: efukudome254580@direct.bilh.masshiway.net
  • Direct secure messaging: eugene.fukudome@direct.signature.masshiway.net

Organizations & group practices 9

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1083740401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT STREET, WACC 435",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT STREET, WACC 435",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUDOME",
        "first_name": "EUGENE",
        "middle_name": "YOSHIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "235136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.