Individual provider Active NPI

Julian Hart Fisher, MD

  • Neurology Physician
  • Brookline, MA
National Provider Identifier
1679573489
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
44315 Issued in MA
Practice address
320 Dudley St
Brookline, MA 02445-5936
Phone
(617) 232-4151
NPI assigned
Jul 22, 2005
Last updated
Apr 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 44315 MA Primary

Addresses

Primary practice location

320 Dudley St
Brookline, MA 02445-5936

Mailing address

320 Dudley St
Brookline, MA 02445-5936
Phone (617) 232-4151

Other identifiers 1

IdentifierTypeStateIssuer
2073714MedicaidMA

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
I20050711000040 MA Practitioner - Pediatric MedicinePractitioner - Neurology 0749216018 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44315MAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 1979 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 28, 2011 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Nov 28, 2011 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc Neurology CurrentSince Jul 1, 1979 Accepting new patients

Locations

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

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1679573489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 DUDLEY ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024455936",
            "telephone_number": "617-232-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 DUDLEY ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024455936",
            "telephone_number": "617-232-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "JULIAN",
        "middle_name": "HART",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "44315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2073714",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.