Individual provider Active NPI

Ioannis Mastoris, MD

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Boston, MA
National Provider Identifier
1124403209
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
291827 Issued in MA
Practice address
55 Fruit St
GRB 800
Boston, MA 02114-2696
Phone
(617) 643-7972
NPI assigned
Jul 30, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 23750 NH
Cardiovascular Disease Physician 207RC0000X 291827 MA
Cardiovascular Disease Physician 207RC0000X 23750 NH
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 291827 MA Primary

Addresses

Primary practice location

55 Fruit St
GRB 800
Boston, MA 02114-2696

Mailing address

PO Box 9142
Charlestown, MA 02129-9142

Other practice location 1

67 Corporate Dr Ste 200
Portsmouth, NH 03801-2847
Phone (603) 610-8070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220901002869 MA Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology) 7214285584 Reassigns benefits to 2 organizations
I20230314000991 NH Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology) 7214285584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
291827MAMDAdvanced Heart Failure and Transplant Cardiology Physician
23750NHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Wentworth Douglass Physician Corporation Cardiovascular Disease CurrentSince Mar 13, 2023 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Mar 13, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Sep 12, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Sep 12, 2022 Accepting new patients

Locations

55 Fruit St
#800
Boston, MA 02114
Phone (617) 724-8052

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

19 Old Rollinsford Rd
Bldg B
Dover, NH 03820
Phone (603) 516-4265

67 Corporate Dr
Ste 200
Portsmouth, NH 03801
Phone (603) 431-5529

67 Corporate Dr
Fl 2
Portsmouth, NH 03801
Phone (603) 610-8078

3 Terrascape Pkwy
Somersworth, NH 03878
Phone (603) 609-6726

Interoperability endpoints

  • Direct secure messaging: mastoris.ioannis.mgh@direct.partners.masshiway.net

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.

Hospital & facility affiliations 6

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1124403209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "GRB 800",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-643-7972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 Corporate Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038012847",
            "country_code": "US",
            "telephone_number": "603-610-8070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTORIS",
        "first_name": "IOANNIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "NH",
            "license": "23750",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "291827",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NH",
            "license": "23750",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "MA",
            "license": "291827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.