Individual provider Active NPI

David Wayne Harrison, MD

  • Pediatrics Physician
  • Everett, MA
National Provider Identifier
1790775369
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
216239 Issued in MA
Practice address
19 Norwood St
Everett, MA 02149-2709
Phone
(617) 394-7500
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 216239 MA
Pediatrics Physician 208000000X 216239 MA Primary

Addresses

Primary practice location

19 Norwood St
Everett, MA 02149-2709

Mailing address

5 Arlington St
Winchester, MA 01890-3701
Phone (857) 334-0884

Other practice location 1

5 Arlington St
Winchester, MA 01890-3701
Phone (857) 334-0884

Other practice location 2

501 Folsom St
San Francisco, CA 94105-3174
Phone (844) 847-8216

Other practice location 3

201 California St Ste 1300
San Francisco, CA 94111-5015
Phone (844) 847-8216

Other identifiers 3

IdentifierTypeStateIssuer
J28526OtherMABCBS MA
468008OtherMATUFTS HEALTH PLAN
2100134MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CA, NC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20040819000816 MA Practitioner - Internal Medicine 9436122108 Reassigns benefits to 3 organizations
I20200504002880 CA Practitioner - Internal Medicine 9436122108 Reassigns benefits to 1 organization
I20220223000727 NC Practitioner - Internal Medicine 9436122108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Harvard Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The General Hospital CorporationGroup PAC ID 6507803806, 1,275 clinicians

Practice addresses (Care Compare)

100 Everett Ave
Chelsea, MA 02150-2309
Phone (617) 887-4600

55 Fruit St
Boston, MA 02114-2621
Phone (617) 726-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216239MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Oct 1, 2006 Accepting new patients
General Hospital Corp Current Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Emerson Hospital Past Accepting new patients

Locations

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

55 Fruit St
Boston, MA 02114

75 Francis St
Boston, MA 02115

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

19 Norwood St
Ste 21
Everett, MA 02149

19 Norwood St
Everett, MA 02149
Phone (617) 388-7500

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

Interoperability endpoints

  • Direct secure messaging: harrison.david.mgh@direct.partners.masshiway.net

Organizations & group practices 6

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1790775369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ARLINGTON ST",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018903701",
            "telephone_number": "857-334-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 NORWOOD ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492709",
            "telephone_number": "617-394-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Arlington St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "MA",
            "postal_code": "018903701",
            "country_code": "US",
            "telephone_number": "857-334-0884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Folsom St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941053174",
            "country_code": "US",
            "telephone_number": "844-847-8216",
            "fax_number": "415-520-9150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 California St Ste 1300",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941115015",
            "country_code": "US",
            "telephone_number": "844-847-8216",
            "fax_number": "415-520-9150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "216239",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "216239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J28526",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "468008",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100134",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

Verify at the official NPI Registry.