Individual provider Active NPI

John V. Wylie Jr., MD

  • Clinical Cardiac Electrophysiology Physician
  • Boston, MA
National Provider Identifier
1720030026
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
214047 Issued in MA
Practice address
736 Cambridge St
CCP4
Boston, MA 02135-2907
Phone
(617) 789-3187
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 214047 MA
Cardiovascular Disease Physician 207RC0000X 214047 MA
Clinical Cardiac Electrophysiology Physician 207RC0001X 214047 MA Primary

Addresses

Primary practice location

736 Cambridge St
CCP4
Boston, MA 02135-2907

Mailing address

960 Massachusetts Ave
Boston, MA 02118-2620
Phone (617) 414-4505

Other practice location 1

25 Libby St
Brockton, MA 02302-2949
Phone (508) 941-7700

Other practice location 2

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

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
I20070103000312 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Cardiac ElectrophysiologyPractitioner - Cardiac Surgery 5799785416 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology
Education
Harvard Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

185 Pilgrim Rd
Boston, MA 02215-5324
Phone (781) 983-9088

25 Libby St
Brockton, MA 02302-2949
Phone (508) 941-7450

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Revere Medical of Massachusetts, PC Internal Medicine CurrentSince Oct 30, 2024 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Aug 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Boston Medical Center - Brighton Corporation Past Accepting new patients

Locations

185 Pilgrim Rd
#4
Boston, MA 02215
Phone (617) 632-7828

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

185 Pilgrim Rd
Boston, MA 02215
Phone (617) 632-8252

11 Nevins St
Brighton, MA 02135
Phone (617) 562-2782

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

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

1 Pearl St
Ste 1000
Brockton, MA 02301
Phone (508) 897-6050

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

25 Libby St
Brockton, MA 02302
Phone (508) 941-7450

300 Mount Auburn St
Ste 310
Cambridge, MA 02138
Phone (617) 497-1560

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

15 Payson Rd
Ste 3
Foxboro, MA 02035
Phone (508) 772-1438

99 Lincoln St
Framingham, MA 01702
Phone (508) 875-4811

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

15 Roche Brothers Way
Ste 110
North Easton, MA 02356
Phone (781) 792-6500

825 Washington St
Ste 340
Norwood, MA 02062
Phone (781) 762-6581

40 Spring St
Watertown, MA 02472
Phone (617) 923-8433

Interoperability endpoints

  • Direct secure messaging: john.wylie@direct.signature.masshiway.net

Organizations & group practices 7

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1720030026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182620",
            "telephone_number": "617-414-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CAMBRIDGE ST",
            "address_2": "CCP4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021352907",
            "telephone_number": "617-789-3187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Libby St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023022949",
            "country_code": "US",
            "telephone_number": "508-941-7700",
            "fax_number": "508-941-6334",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "JOHN",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "214047",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "214047",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MA",
            "license": "214047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.