Individual provider Active NPI

Alyssa Raven Hertz Thomas, MD

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1134612211
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
286999 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6106
Phone
(617) 732-5500
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 286999 MA Primary
Pediatrics Physician 208000000X MT214912 PA

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6106

Mailing address

300 Longwood Ave # 961
Boston, MA 02115-5724

Other practice location 1

3401 Civic Center Blvd Rm 55
Philadelphia, PA 19104-4319
Phone (215) 590-1220

Other practice location 2

300 Longwood Ave # 961
Boston, MA 02115-5724
Phone (617) 919-2341

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
I20240617001419 MA Practitioner - Pediatric Medicine 3577006790 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
286999MAMDPediatrics Physician
MT214912PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jul 1, 2024 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Jun 1, 2024 Accepting new patients
Brigham & Womens Hospital, Inc. Past Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatrics PastSince Jun 1, 2021 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

Interoperability endpoints

  • Direct secure messaging: athomas252294@direct.bilh.masshiway.net
  • Direct secure messaging: athomas28468@direct.bostonchildrens.org
  • Direct secure messaging: thomas.alyssa.bwh@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.

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1134612211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE # 961",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724"
        },
        {
            "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": "617-732-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd Rm 55",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Longwood Ave # 961",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-919-2341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ALYSSA",
        "middle_name": "RAVEN HERTZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "286999",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT214912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.