Individual provider Active NPI

Julie L Tishler, M.D.

  • Internal Medicine Physician
  • Roxbury, MA
National Provider Identifier
1093755530
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
154585 Issued in MA
Practice address
55 Dimock St
Roxbury, MA 02119-1029
Phone
(617) 442-8800
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 154585 MA Primary

Addresses

Primary practice location

55 Dimock St
Roxbury, MA 02119-1029

Mailing address

55 Dimock St
Roxbury, MA 02119-1029
Phone (617) 442-8800

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
I20040310000126 MA Practitioner - Internal Medicine 4284522293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Maryland School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pratt Medical Group IncGroup PAC ID 3375515661, 282 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Canton, MA, CCN 227551
  • Visiting Nurse Association of Boston Home health agency, Dorchester, MA, CCN 227068
  • Pathways Healthcare Home health agency, Westwood, MA, CCN 227569
  • Tufts Medical Center Hospital, Boston, MA, CCN 220116

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc Internal Medicine CurrentSince Jul 13, 2015 Accepting new patients
Pratt Medical Group, Inc CurrentSince Jul 13, 2015 Accepting new patients

Locations

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

Organizations & group practices 2

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 5

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1093755530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISHLER",
        "first_name": "JULIE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "154585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.