Individual provider Active NPI

Peter J Fagenholz, M.D.

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1346319480
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
228955 Issued in MA
Practice address
M.G.H.,Dept. of Surgery
55 Fruit Street, GRB 425
Boston, MA 02114
Phone
(617) 726-3000
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 228955 MA Primary

Addresses

Primary practice location

M.G.H.,Dept. of Surgery
55 Fruit Street, GRB 425
Boston, MA 02114

Mailing address

17 Bishop Richard Allen Dr
Cambridge, MA 02139-3524
Phone (617) 726-3000

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
I20110713000691 MA Practitioner - General SurgeryPractitioner - Emergency Medicine 2466620653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Emergency Medicine
Education
New York University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

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

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228955MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 1, 2011 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Surgery CurrentSince Jul 1, 2011 Accepting new patients

Locations

55 Fruit St
#425
Boston, MA 02114
Phone (617) 726-2800

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

Interoperability endpoints

  • Direct secure messaging: fagenholz.peter.mgh@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 6

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346319480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BISHOP RICHARD ALLEN DR",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021393524",
            "telephone_number": "617-726-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "M.G.H.,DEPT. OF SURGERY",
            "address_2": "55 FRUIT STREET, GRB 425",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-726-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGENHOLZ",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "228955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.