Individual provider Active NPI

Adam Roman Puchalski, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1265894877
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
141192 Issued in CA
Practice address
55 Fruit St
Boston, MA 02114-2696
Phone
(617) 726-4400
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD-23805 HI
Internal Medicine Physician 207R00000X 141192 CA Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 292322 MA

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2696

Mailing address

55 Fruit St
Boston, MA 02114-2696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA, HI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180727001549 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 1052668605 Reassigns benefits to 1 organization
I20221116000979 MA Practitioner - Endocrinology 1052668605 Reassigns benefits to 3 organizations
I20260515003296 HI Practitioner - Internal Medicine 1052668605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

124 Macaw LN
Simi Valley, CA 93065-3152
Phone (805) 306-0304

2950 Sycamore Dr
Simi Valley, CA 93065-1210

480 Lynnfield St
Lynn, MA 01904-1419
Phone (781) 593-3400

50 Staniford St
Boston, MA 02114-2517

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236
  • 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
141192CAMDInternal Medicine Physician
MD-23805HIMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Oct 1, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients
Adventist Health Physicians Network CurrentSince Dec 1, 2025 Accepting new patients
Adventist Health Physicians Network Internal Medicine Current Accepting new patients
Adventist Health Physicians Network CurrentSince Dec 1, 2025 Accepting new patients
Mass General Brigham Medical Group Northern Massachusetts Inc Internal Medicine CurrentSince Dec 16, 2022 Accepting new patients
Adventist Health Heart Institute-Ukiah Past Accepting new patients

Locations

124 Macaw Ln
Simi Valley, CA 93065
Phone (805) 306-0304

55 Fruit St
Boston, MA 02114

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

104 Endicott St
Ste 104
Danvers, MA 01923
Phone (978) 882-6700

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

480 Lynnfield St
Lynn, MA 01904
Phone (781) 581-3280

Interoperability endpoints

  • Direct secure messaging: puchalski.adam.nsmc@direct.partners.masshiway.net
  • Direct secure messaging: apuchalski21216@hhsc.direct-ci.com

Organizations & group practices 9

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 3

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1265894877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCHALSKI",
        "first_name": "ADAM",
        "middle_name": "ROMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "HI",
            "license": "MD-23805",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "141192",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "292322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.