Individual provider Active NPI

Donald M Foxworthy, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1558336289
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53686 Issued in MA
Practice address
133 Brookline Ave
Internal Medicine
Boston, MA 02215-3904
Phone
(617) 421-5804
Fax
(617) 421-8865
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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 53686 MA Primary

Addresses

Primary practice location

133 Brookline Ave
Internal Medicine
Boston, MA 02215-3904

Mailing address

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Other practice location 1

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Other identifiers 5

IdentifierTypeStateIssuer
053686OtherMATUFTS
3104290MedicaidMA
J03548OtherMABLUE CROSS
PM327OtherMAHARVARD PILGRIM
110052441AMedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dfoxworthymd2599@direct.atrius.masshiway.net

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
I20050406000298 MA Practitioner - Internal Medicine 2466409073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Michigan Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Codman Square Health Center, IncGroup PAC ID 8123013869, 67 clinicians

Practice addresses (Care Compare)

637 Washington St
Dorchester, MA 02124-3510
Phone (617) 825-9660

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Codman Square Health Center Inc CurrentSince Oct 1, 2022 Accepting new patients

Locations

637 Washington St
Dorchestr Ctr, MA 02124
Phone (617) 822-8211

Interoperability endpoints

  • Direct secure messaging: dfoxworthymd2599@direct.atrius.masshiway.net
  • Direct secure messaging: dfoxworthy182319@direct.bmc.masshiway.net

Organizations & group practices 1

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 9

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1558336289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WASHINGTON ST",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021243510",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BROOKLINE AVE",
            "address_2": "INTERNAL MEDICINE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153904",
            "telephone_number": "617-421-5804",
            "fax_number": "617-421-8865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "637 Washington St",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021243510",
            "country_code": "US",
            "telephone_number": "617-825-9660",
            "fax_number": "617-288-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOXWORTHY",
        "first_name": "DONALD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "53686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "053686",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3104290",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J03548",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "PM327",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110052441A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfoxworthymd2599@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "133 Brookline Ave",
            "address_2": "Internal Medicine",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "022153904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.