Individual provider Active NPI

Collin M. Stultz, M.D.

  • Cardiovascular Disease Physician
  • Boston, MA
National Provider Identifier
1932283520
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
213812 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-6660
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 213812 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

111 Saint Paul St
#2F
Brookline, MA 02446-5146
Phone (617) 253-4961

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
I20101220000513 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4385832203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Harvard Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213812MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Aug 1, 2017 Accepting new patients
The General Hospital Corporation CurrentSince Aug 1, 2017 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

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

55 Fruit St
#9
Boston, MA 02114
Phone (617) 724-3874

75 Francis St
Boston, MA 02115

55 Fruit St
Ste 9
Boston, MA 02114
Phone (617) 724-8770

Interoperability endpoints

  • Direct secure messaging: stultz.collin.mgh@direct.partners.masshiway.net

Organizations & group practices 3

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 3

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932283520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SAINT PAUL ST",
            "address_2": "#2F",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024465146",
            "telephone_number": "617-253-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULTZ",
        "first_name": "COLLIN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "213812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.