Bonnie Ann Southworth, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

79458 Issued in MA

Practice address

75 Francis St
Boston, MA 02115

Phone

(612) 732-6315

NPI assigned

Apr 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Washington University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
• Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
• Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119
• Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
• Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
• North Shore Medical Center - Hospital, Salem, MA, CCN 220035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: southworth.bonnie.bwh@direct.partners.masshiway.net

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.

• Brigham & Womens Physicians Organization Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1033535497
  Medicare reassignment Care Compare group
• Brigham and Women'S Hospital

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1093885816
  NPD
• Brigham and Womens Physicians Organization Inc

  • Diagnostic Radiology Physician
  • Boston, MA
  • NPI 1265464598
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mass General Brigham Home Care, Inc.

  • Home Health Agency
  • Newton, MA
  • NPI 1083644017
  Care Compare affiliation Name & address match
• Brigham & Womens Hospital, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1790717650
  Care Compare affiliation
• Brigham and Women'S Faulkner Hospital, Inc

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1578677811
  Care Compare affiliation
• Brigham and Women'S Faulkner Hospital, Inc.

  • Psychiatric Hospital Unit
  • Boston, MA
  • NPI 1033121025
  Care Compare affiliation
• Newton-Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1992737761
  Care Compare affiliation
• North Shore Medical Center, Inc.

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Care Compare affiliation

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1891752291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CYPRESS ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "02445",
            "telephone_number": "857-307-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "612-732-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWORTH",
        "first_name": "BONNIE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "79458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3128580",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Shore Eye Care, P.C.
• Sharon Southard
• Darrius Southwell
• Elizabeth Southwick, RN
• Heather Southwick, PT
• Corey L Southworth, CRNA
• Martha Claire Southworth, MSW LICSW
• Betina Lirio de Souza-Bagley
• Daniel At Souza, M.D.
• Rosemary H Souza, NP

• Internal Medicine Physician in Boston, MA
• Providers in Boston, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.