NPIMap

Individual provider Active NPI

Douglas Middleton Dahl, MD

  • Urology Physician
  • Boston, MA
National Provider Identifier
1639160807
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
78119 Issued in MA
Practice address
55 Fruit St
GRB 1102
Boston, MA 02114-2621
Phone
(617) 726-0875
Fax
(617) 726-6131
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 78119 MA Primary

Addresses

Primary practice location

55 Fruit St
GRB 1102
Boston, MA 02114-2621

Mailing address

PO Box 9142
Charlestown, MA 02129-9142
Phone (617) 726-0875

Other identifiers 3

IdentifierTypeStateIssuer
J31467OtherMABCBS MA
3141063MedicaidMA
779428OtherMATUFTS HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040709000163 MA Practitioner - Urology 9931187788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Yale University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

102 Endicott St
MGH North Shore Medical
Danvers, MA 01923-3623
Phone (978) 882-6100

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
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Prostate resection40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Jul 24, 1995 Accepting new patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Oct 1, 2006 Accepting new patients

Locations

55 Fruit St
#1102
Boston, MA 02114
Phone (617) 726-3010

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

15 Parkman St
#528
Boston, MA 02114
Phone (617) 726-0875

Interoperability endpoints

  • Direct secure messaging: dahl.douglas.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 5

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391126400000",
    "number": "1639160807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-726-0875",
            "fax_number": "617-726-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "GRB 1102",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-0875",
            "fax_number": "617-726-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "DOUGLAS",
        "middle_name": "MIDDLETON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2014-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "78119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J31467",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3141063",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "779428",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.