Individual provider Active NPI

Natalia Ganson-Myshkin, M.D.

  • Internal Medicine Physician
  • Dorchester Center, MA
National Provider Identifier
1457340515
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
75596 Issued in MA
Practice address
2110 Dorchester Ave
Dorchester Center, MA 02124-5628
Phone
(617) 436-3786
Fax
(617) 296-5778
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 75596 MA Primary

Addresses

Primary practice location

2110 Dorchester Ave
Dorchester Center, MA 02124-5628

Mailing address

2110 Dorchester Ave Ste 311
Seton Medical Office Building
Dorchester, MA 02124-5615
Phone (617) 296-0456

Other identifiers 5

IdentifierTypeStateIssuer
J12678OtherMABLUE CROSS/BLUE SHIELD
3095347MedicaidMA
64121OtherMAHARVARD PILGRIM HEALTHCAR
B10065602OtherCIGNA HEALTHCARE
075596OtherTUFTS ASSOCIATED HEALTH P

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
I20040602000150 MA Practitioner - Internal Medicine 1759363070 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75596MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Southeast Anesthesia Assoc Past Accepting new patients
Carney Medical Group Past Accepting new patients
Boston Medical Group, PC Past Accepting new patients

Locations

77 Warren St
Brighton, MA 02135
Phone (617) 254-1271

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

2110 Dorchester Ave
Ste 310
Dorchestr Ctr, MA 02124
Phone (617) 296-0720

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

2110 Dorchester Ave
Ste 311
Dorchestr Ctr, MA 02124
Phone (617) 296-0456

2100 Dorchester Ave
Fl 7
Dorchestr Ctr, MA 02124
Phone (617) 296-4012

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

40 Spring St
Watertown, MA 02472
Phone (617) 923-8433

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457340515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 DORCHESTER AVE STE 311",
            "address_2": "SETON MEDICAL OFFICE BUILDING",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 DORCHESTER AVE",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021245628",
            "telephone_number": "617-436-3786",
            "fax_number": "617-296-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSON-MYSHKIN",
        "first_name": "NATALIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "75596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "J12678",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3095347",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "64121",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "B10065602",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS ASSOCIATED HEALTH P",
            "identifier": "075596",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester Center, MA

Sources for this page

Verify at the official NPI Registry.