NPIMap

Individual provider Active NPI

Bilal Fawaz, M.D.

  • Dermatology Physician
  • Boston, MA
National Provider Identifier
1710336722
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
285459 Issued in MA
Practice address
725 Albany St # 8B
Boston, MA 02118-3549
Phone
(617) 638-7420
Fax
(617) 638-7289
NPI assigned
Jun 9, 2016
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 285459 MA Primary

Addresses

Primary practice location

725 Albany St # 8B
Boston, MA 02118-3549

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other practice location 1

447 W 4th St # 1
Boston, MA 02127-2653
Phone (617) 297-8051

Other identifiers 2

IdentifierTypeStateIssuer
3135073MedicaidNH
110164584AMedicaidMA

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
I20201002002944 MA Practitioner - Dermatology 3375821317 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Texas a & M University System, HSC, College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University Dermatology IncGroup PAC ID 7012803919, 15 clinicians
South Shore Medical Center, Inc.Group PAC ID 3678487444, 174 clinicians
South Boston Community Health CenterGroup PAC ID 2062487291, 57 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (614) 763-8848

1495 Hancock St
Quincy, MA 02169-5229
Phone (781) 878-5200

409 W Broadway
South Boston, MA 02127-2245
Phone (617) 269-7500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision25
Removal of skin lesions167
Removal or shaving of skin growth1-10
Skin biopsy82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285459MAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Boston University Dermatology, Inc. Dermatology CurrentSince Jul 15, 2021 Accepting new patients
South Boston Community Health Center CurrentSince Sep 6, 2023 Accepting new patients
Dermatology Physicians of South Jersey, PA PastSince Dec 13, 2020 Accepting new patients

Locations

930 Commonwealth Ave
Boston, MA 02215
Phone (617) 262-2020

960 Massachusetts Ave
Ste 2
Boston, MA 02118

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

801 Albany St
Fl G
Roxbury, MA 02119

409 W Broadway
South Boston, MA 02127
Phone (617) 269-7500

Interoperability endpoints

  • Direct secure messaging: bfawaz132026@direct.bmc.masshiway.net
  • Direct secure messaging: bfawaz669140@direct.ochin.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1710336722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST # 8B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183549",
            "telephone_number": "617-638-7420",
            "fax_number": "617-638-7289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "447 W 4th St # 1",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021272653",
            "country_code": "US",
            "telephone_number": "617-297-8051",
            "fax_number": "617-613-7920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWAZ",
        "first_name": "BILAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "285459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3135073",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110164584A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.