Individual provider Active NPI

Philip Ryan Molarte Camilon, M.D.

  • Pediatric Otolaryngology Physician
  • Danvers, MA
National Provider Identifier
1285049510
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
1016606 Issued in MA
Practice address
104 Endicott St Ste 100
Danvers, MA 01923-0009
Phone
(978) 745-6601
Fax
(978) 744-4872
NPI assigned
Jun 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 1016606 MA
Pediatric Otolaryngology Physician 207YP0228X 11273467-1205 UT
Surgery Physician 208600000X 37240 SC
Pediatric Otolaryngology Physician 207YP0228X 1016606 MA Primary

Addresses

Primary practice location

104 Endicott St Ste 100
Danvers, MA 01923-0009

Mailing address

104 Endicott St Ste 100
Danvers, MA 01923-0009
Phone (978) 745-6601

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
I20240110001080 MA Practitioner - Otolaryngology 0648492538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Boston University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Ear, Nose and Throat Associates, PCGroup PAC ID 9032138367, 17 clinicians

Practice addresses (Care Compare)

104 Endicott St
Suite 100
Danvers, MA 01923-0009
Phone (978) 745-6601

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37240SCMDPharmacist
11273467-1205UTMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Philip Ryan M Camilon, MD Otolaryngology Current Accepting new patients
North Shore Ear, Nose & Throat Associates, PC Otolaryngology CurrentSince Dec 20, 2023 Accepting new patients
North Shore Ear, Nose & Throat Associates Otolaryngology Current Accepting new patients

Locations

505 S Main St
Ste 275
Orange, CA 92868
Phone (714) 836-6607

100 Cummings Ctr
Ste 136G
Beverly, MA 01915

104 Endicott St
Ste 100
Danvers, MA 01923
Phone (978) 745-6601

Interoperability endpoints

  • Direct secure messaging: camilon.philipryan.nsent@direct.partners.masshiway.net

Organizations & group practices 3

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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1285049510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST STE 100",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019230009",
            "telephone_number": "978-745-6601",
            "fax_number": "978-744-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ENDICOTT ST STE 100",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019230009",
            "telephone_number": "978-745-6601",
            "fax_number": "978-744-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMILON",
        "first_name": "PHILIP RYAN",
        "middle_name": "MOLARTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "1016606",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "UT",
            "license": "11273467-1205",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "37240",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MA",
            "license": "1016606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.