Vitaly E Ermolin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME 88741 Issued in FL

Practice address

55 Fogg Rd
Weymouth, MA 02190-2432

Phone

(781) 624-8000

Fax

(781) 878-6750

NPI assigned

Dec 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

HospitalistAlso: Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Shore Hospital Hospital, South Weymouth, MA, CCN 220100
• Dana-Farber Cancer Institute Hospital, Boston, MA, CCN 220162

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as group

Quality

88.12

Promoting interoperability

71

Improvement activities

40

Cost

77.69

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Coastal Medical Associates

  • Anesthesiology Physician
  • Weymouth, MA
  • NPI 1932175684
  Medicare reassignment Care Compare group NPD
• Sound Physicians of Massachusetts II PC

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1306376397
  Medicare reassignment NPD
• Sound Physicians of Massachusetts Inc

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1740678408
  Medicare reassignment NPD
• Sound Physicians of Massachusetts Inc

  • Internal Medicine Physician
  • North Adams, MA
  • NPI 1205164951
  NPD
• Sound Physicians of Massachusetts, Inc

  • Internal Medicine Physician
  • Stoughton, MA
  • NPI 1245784446
  NPD
• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  NPD (past)
• Jay Care Medical Center, Inc.

  • Primary Care Clinic/Center
  • Lakeland, FL
  • NPI 1457336182
  NPD (past)

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

• Dana-Farber Cancer Institute, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1851333686
  Care Compare affiliation
• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  Care Compare affiliation

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1114901485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 LONGWATER DR STE 201",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611620",
            "telephone_number": "781-792-4136",
            "fax_number": "781-878-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021902432",
            "telephone_number": "781-624-8000",
            "fax_number": "781-878-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERMOLIN",
        "first_name": "VITALY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "246085",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 88741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268992800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael P Ennis, CRNA
• Joseph Ephrem
• Kara K Erdody, NP
• Eric Diener Inc.
• Barbara Erkson
• Julie Lyn Estey, MSW
• Brenda Etheridge-Johnson
• Melissa Evans, MS OTR/L
• James R Everett, M.D.
• Heather Kathryn Ewell, LCSW

• Internal Medicine Physician in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.