Individual provider Active NPI

Brendan Bormes

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1194288548
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-3030
NPI assigned
Apr 11, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 1016973 MA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

3800 Reservoir Road NW
Dept of Anesthesia
Washington DC, DC 20007
Phone (202) 444-8556

Other practice location 1

3800 Reservoir Road NW
Dept of Anesthesia
Washington DC, DC 20007
Phone (202) 444-8556

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
I20230815003397 MA Practitioner - Anesthesiology 2668834136 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Medical Group, Inc.Group PAC ID 3971987108, 140 clinicians

Practice addresses (Care Compare)

47 Middlesex Tpke
Burlington, MA 01803-4945
Phone (857) 282-8100

81 Highland Ave
Salem, MA 01970-2714
Phone (617) 726-4121

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1016973MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Aug 1, 2023 Accepting new patients
Mass General Brigham Medical Group, Inc. Anesthesiology CurrentSince Apr 1, 2024 Accepting new patients
The General Hospital Corporation CurrentSince Aug 1, 2023 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

47 Middlesex Tpke
Burlington, MA 01803
Phone (857) 282-8100

Interoperability endpoints

  • Direct secure messaging: bormes.brendan.mgh@direct.partners.masshiway.net

Organizations & group practices 4

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 2

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": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1194288548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR ROAD NW",
            "address_2": "DEPT OF ANESTHESIA",
            "city": "WASHINGTON DC",
            "state": "DC",
            "postal_code": "20007",
            "telephone_number": "202-444-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-3030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Reservoir Road NW",
            "address_2": "Dept of Anesthesia",
            "address_purpose": "LOCATION",
            "city": "Washington DC",
            "state": "DC",
            "postal_code": "20007",
            "country_code": "US",
            "telephone_number": "202-444-8556",
            "fax_number": "202-444-8854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORMES",
        "first_name": "BRENDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "1016973",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.