Individual provider Active NPI

Ethan Morris, PA

  • Medical Physician Assistant
  • Boston, MA
National Provider Identifier
1255728622
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA5450 Issued in MA
Practice address
55 Fruit Street
Boston, MA 02241-3308
Phone
(617) 726-2000
NPI assigned
Apr 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA5450 MA Primary

Addresses

Primary practice location

55 Fruit Street
Boston, MA 02241-3308

Mailing address

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925000826 MA Practitioner - Physician Assistant 6002124989 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of North Dakota School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-2551

Salem Hospital Medical Staff Office
81 Highland Ave Wheelock 6
Salem, MA 01970-2714

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA5450MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brockton Hospital, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Brockton Hospital, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince May 19, 2025 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

15 Parkman St
Boston, MA 02114
Phone (617) 726-3023

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

62 13th St
Charlestown, MA 02129
Phone (617) 724-4260

Interoperability endpoints

  • Direct secure messaging: morris.ethan.nsmc@direct.partners.masshiway.net

Organizations & group practices 6

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 1

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": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1255728622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7000",
            "fax_number": "508-941-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022413308",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "ETHAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA5450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.