Individual provider Active NPI

Philip R. Dormitzer, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1255389979
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151131 Issued in MA
Practice address
320 Longwood Ave
Enders 673, Children's Hospital
Boston, MA 02115-5746
Phone
(617) 355-3026
NPI assigned
May 5, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 151131 MA Primary
Infectious Disease Physician 207RI0200X 151131 MA

Addresses

Primary practice location

320 Longwood Ave
Enders 673, Children's Hospital
Boston, MA 02115-5746

Mailing address

320 Longwood Ave
Enders 673, Children's Hospital
Boston, MA 02115-5746
Phone (617) 355-3026

Other identifiers 1

IdentifierTypeStateIssuer
0110809MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151131MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Medical Associates, P.C. Internal Medicine PastSince May 26, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1255389979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 LONGWOOD AVE",
            "address_2": "ENDERS 673, CHILDREN'S HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155746",
            "telephone_number": "617-355-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 LONGWOOD AVE",
            "address_2": "ENDERS 673, CHILDREN'S HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155746",
            "telephone_number": "617-355-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMITZER",
        "first_name": "PHILIP",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "151131",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "151131",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110809",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.