Individual provider Active NPI

Molly J Douglas, M.D.

  • Surgery Physician
  • Boston, MA
National Provider Identifier
1609212695
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
273931 Issued in MA
Practice address
110 Francis St Ste 3a
Boston, MA 02215
Phone
(617) 632-9922
Fax
(617) 632-0886
NPI assigned
May 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 273931 MA Primary

Addresses

Primary practice location

110 Francis St Ste 3a
Boston, MA 02215

Mailing address

110 Francis St Ste 3a
Boston, MA 02215-5501
Phone (617) 632-9922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180830001141 MA Practitioner - General Surgery 5294977757 Reassigns benefits to 3 organizations
I20190927002160 AZ Practitioner - General Surgery 5294977757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Tufts University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 1
Tucson, AZ 85719-1454
Phone (520) 694-2873

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Dec 26, 2022 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Surgery CurrentSince Jul 24, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 24, 2018 Accepting new patients
Banner-University Medical Group CurrentSince Sep 1, 2019 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 25, 2018 Accepting new patients
Banner-University Medical Group Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 26, 2022 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 25, 2018 Accepting new patients
Banner - University Medical Center Tucson Campus LLC Past Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

3838 N Campbell Ave
Bldg 1
Tucson, AZ 85719
Phone (520) 694-2873

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

1625 N Campbell Ave
Tucson, AZ 85719

110 Francis St
Boston, MA 02215
Phone (617) 632-7246

110 Francis St
Ste 3A
Boston, MA 02215
Phone (617) 632-9780

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

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

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

Organizations & group practices 10

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 3

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1609212695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST STE 3A",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155501",
            "telephone_number": "617-632-9922",
            "fax_number": "617-632-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANCIS ST STE 3A",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-632-9922",
            "fax_number": "617-632-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "MOLLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "273931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.