Individual provider Active NPI

Eric James Nilles, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Boston, MA
National Provider Identifier
1124007109
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
270618 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6106
Phone
(781) 995-7077
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 270618 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6106

Mailing address

43 Hancock St
Lexington, MA 02420-3433
Phone (781) 995-7077

Other practice location 1

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-6360

Other identifiers 2

IdentifierTypeStateIssuer
36963OtherIAWELLMARK BCBS
0443473MedicaidIA

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
I20170814000812 MA Practitioner - Emergency Medicine 5597733527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Wisconsin School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

  • Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270618MAMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Sep 1, 2017 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients

Locations

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

Interoperability endpoints

  • Direct secure messaging: nilles.eric.bwh@direct.partners.masshiway.net

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 3

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1124007109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 HANCOCK ST",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024203433",
            "telephone_number": "781-995-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "781-995-7077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-6360",
            "fax_number": "319-384-9184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NILLES",
        "first_name": "ERIC",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MA",
            "license": "270618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "36963",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0443473",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.