Individual provider Active NPI

Michael Ferris, MD

  • Pediatrics Physician
  • Dedham, MA
National Provider Identifier
1811993447
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
153280 Issued in MA
Practice address
1 Lyons St
Dedham, MA 02026-5599
Phone
(781) 329-1400
Fax
(781) 278-5667
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 153280 MA Primary

Addresses

Primary practice location

1 Lyons St
Dedham, MA 02026-5599

Mailing address

188 Mill St
Burlington, MA 01803-1869
Phone (781) 221-5653

Other identifiers 17

IdentifierTypeStateIssuer
153280OtherTUFTS BENEFIT ADMINISTRAT
3174531OtherMASS HEALTH (DIV OF MEDSV
G11682OtherFIRST SENIORITY
G11682OtherHARVARD PILGRIM POS
G11682OtherHARVARD PILGRIM
J18335OtherBS-BLUECARE ELECT
G11682OtherHARVARD PILGRIM PPO
0011199OtherNEIGHBORHOOD HEALTH PLAN
153280OtherTUFTS TOTAL HEALTH PLAN
J18335OtherHMO BLUE/BLUE CHOICE
7999027OtherHEALTHSOURCE MASSACHUSETT
27394OtherCHILDRENS MEDICAL SECURIT
153280OtherTUFTS
12-01710OtherUNITED HEALTHCARE PPO
153280OtherTUFTS COMMONWEALTH PPO
7999027OtherCIGNA HEALTH CARE
J18335OtherBLUE SHIELD INDEMNITY

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
I20060619000155 MA Practitioner - Pediatric MedicinePractitioner - Internal Medicine 2961414784 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
153280MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Aug 1, 2018 Accepting new patients
The General Hospital Corporation CurrentSince Aug 1, 2018 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1811993447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 MILL ST",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018031869",
            "telephone_number": "781-221-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LYONS ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020265599",
            "telephone_number": "781-329-1400",
            "fax_number": "781-278-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRIS",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "153280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS BENEFIT ADMINISTRAT",
            "identifier": "153280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH (DIV OF MEDSV",
            "identifier": "3174531",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SENIORITY",
            "identifier": "G11682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM POS",
            "identifier": "G11682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "G11682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS-BLUECARE ELECT",
            "identifier": "J18335",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PPO",
            "identifier": "G11682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0011199",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS TOTAL HEALTH PLAN",
            "identifier": "153280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE/BLUE CHOICE",
            "identifier": "J18335",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE MASSACHUSETT",
            "identifier": "7999027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MEDICAL SECURIT",
            "identifier": "27394",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "153280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PPO",
            "identifier": "12-01710",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS COMMONWEALTH PPO",
            "identifier": "153280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "7999027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "J18335",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.