Individual provider Active NPI

Dana C Miskulin, MD

  • Nephrology Physician
  • Boston, MA
National Provider Identifier
1922046721
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
213820 Issued in MA
Practice address
800 Washington St
Box 391
Boston, MA 02111-1552
Phone
(617) 636-5866
NPI assigned
Jun 3, 2006
Last updated
Feb 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 213820 MA Primary

Addresses

Primary practice location

800 Washington St
Box 391
Boston, MA 02111-1552

Mailing address

11 Chapel St
Somerville, MA 02144-1901
Phone (617) 628-0910

Other identifiers 13

IdentifierTypeStateIssuer
213280OtherMATUFTS
0026924OtherMANEIGHBORHOOD HEALTH PLAN
31-00287OtherMAUNITED HEALTHCARE
7356345OtherMAAETNA/US HEALTHCA NON-HMO
J24821OtherMABLUE SHIELD INDEMNIT
J24821OtherMAHMO BLUE / BLUE CARE ELEC
04-2743894OtherMAUNICARE
10322OtherMAHARVARD PILGRIM
2809283OtherMAAETNA/US HEALTHCARE
1454175002OtherMACIGNA/HEALTHSOURCE PRATT
CIGNA SCP 5368325003OtherMACIGNA SCP
A34171MedicaidMA
HCVM TAX ID# 04-2743OtherMAHCVM TAX ID# 04-2743894

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
I20040726000287 MA Practitioner - Nephrology 2264412659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pratt Medical Group IncGroup PAC ID 3375515661, 282 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 369-1400

585 Lebanon St
Melrose, MA 02176-3225
Phone (617) 636-5000

643 Broadway
Somerville, MA 02145-2528
Phone (617) 616-3600

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213820MAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc CurrentSince Jun 1, 2002 Accepting new patients
Pratt Medical Group, Inc Nephrology Current Accepting new patients
Pratt Medical Group, Inc CurrentSince Jun 1, 2002 Accepting new patients
Pratt Medical Group, Inc Nephrology Past Accepting new patients
Pratt Medical Group, Inc Past Accepting new patients
Tufts Medical Center, Inc. Past Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#1
Boston, MA 02111

800 Washington St
#391
Boston, MA 02111
Phone (617) 636-2240

736 Cambridge St
#7
Brighton, MA 02135
Phone (617) 789-2588

Interoperability endpoints

  • Direct secure messaging: dmiskulin28801@tuftsmedicine.direct-ci.com

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

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1922046721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CHAPEL ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021441901",
            "telephone_number": "617-628-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "BOX 391",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISKULIN",
        "first_name": "DANA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "213820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "213280",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0026924",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "31-00287",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCA NON-HMO",
            "identifier": "7356345",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNIT",
            "identifier": "J24821",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE / BLUE CARE ELEC",
            "identifier": "J24821",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "04-2743894",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "10322",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE",
            "identifier": "2809283",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA/HEALTHSOURCE PRATT",
            "identifier": "1454175002",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA SCP",
            "identifier": "CIGNA SCP 5368325003",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A34171",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCVM TAX ID# 04-2743894",
            "identifier": "HCVM TAX ID# 04-2743",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.