Individual provider Active NPI

Thomas Schnelldorfer, MD

  • Surgery Physician
  • Burlington, MA
National Provider Identifier
1588757348
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
250305 Issued in MA
Practice address
Lahey Clinic
41 Mall Road
Burlington, MA 01805-0001
Phone
(781) 744-8000
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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 250305 MA Primary

Addresses

Primary practice location

Lahey Clinic
41 Mall Road
Burlington, MA 01805-0001

Mailing address

Lahey Clinic
41 Mall Road
Burlington, MA 01805-0001
Phone (781) 744-8000

Other identifiers 1

IdentifierTypeStateIssuer
110092813AMedicaidMA

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
I20120723000708 MA Practitioner - General Surgery 0042217762 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pratt Surgical Associates IncGroup PAC ID 4486546082, 44 clinicians
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

91 Montvale Ave
Suite 208
Stoneham, MA 02180-3649
Phone (781) 306-6166

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)12
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250305MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc Surgery CurrentSince Nov 22, 2024 Accepting new patients
Lahey Clinic, Inc CurrentSince Jul 1, 2012 Accepting new patients
Pratt Surgical Associates Inc Surgery CurrentSince Jul 1, 2021 Accepting new patients
Melrosewakefield Healthcare, Inc. Past Accepting new patients
Tufts Medical Center, Inc. Past Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#1013
Boston, MA 02111
Phone (617) 636-0491

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

959 Concord St
Ste 200
Framingham, MA 01701
Phone (508) 532-0223

1690 Crown Colony Dr
Quincy, MA 02169
Phone (781) 237-3395

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

41 Montvale Ave
Stoneham, MA 02180
Phone (781) 224-5806

91 Montvale Ave
Ste 208
Stoneham, MA 02180
Phone (781) 279-1123

91 Montvale Ave
Stoneham, MA 02180
Phone (781) 279-1952

Interoperability endpoints

  • Direct secure messaging: tschnelldorfer32173@tuftsmedicine.direct-ci.com

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.

Hospital & facility affiliations 2

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1588757348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAHEY CLINIC",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAHEY CLINIC",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNELLDORFER",
        "first_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "250305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110092813A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.