Individual provider Active NPI

Thomas Dag Horn, MD

  • Dermatology Physician
  • Boston, MA
National Provider Identifier
1275620320
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
E-1269 Issued in AR
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(176) 658-9300
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X E-1269 AR
Dermatology Physician 207N00000X E-1269 AR Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

55 Fruit St
Boston, MA 02114-2696
Phone (176) 586-9300

Other identifiers 1

IdentifierTypeStateIssuer
131654001MedicaidAR

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
I20070522000102 MA Practitioner - DermatologyPractitioner - Pathology 3476650763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
University of Virginia School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

50 Staniford St
Boston, MA 02114-2517

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230717MAMDClinical Social Worker
E-1269ARMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Oct 29, 2011 Accepting new patients
Massachusetts General Physicians Organization Inc Dermatology CurrentSince Oct 29, 2011 Accepting new patients
Metroplex Pathology Associates CurrentSince Jan 13, 2010 Accepting new patients
General Hospital Corp Current Accepting new patients
Cohen Dermatopathology, PC Dermatopathology PastSince Jan 13, 2010 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

15 Crawford St
Ste 100
Needham Heights, MA 02494
Phone (617) 969-4100

2 Wells Ave
Newton, MA 02459
Phone (617) 658-9300

320 Needham St
Ste 200
Newton Upper Falls, MA 02464
Phone (617) 969-4100

Interoperability endpoints

  • Direct secure messaging: horn.thomas.mgh@direct.partners.masshiway.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1275620320",
    "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",
            "telephone_number": "176-586-9300"
        },
        {
            "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": "176-658-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "THOMAS",
        "middle_name": "DAG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "AR",
            "license": "E-1269",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AR",
            "license": "E-1269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131654001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.