Active NPI
Philip R. Dormitzer, M.D.
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1255389979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 151131
- 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, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0110809 | Medicaid | MA |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 151131 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Medical Associates, P.C. | Internal Medicine | Past | 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.
-
- Internal Medicine Physician
- Braintree, MA
- NPI 1235183955
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.