NPIMap

Organization Active NPI

Bumc Otolaryngologic Foundation, Inc.

  • Otolaryngology Physician
  • Boston, MA
National Provider Identifier
1942257159
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
BUMC OTOLARYNGOLOGIC FOUNDATION, INC.
Practice address
830 Harrison Ave
Suite 1400
Boston, MA 02118-2905
Phone
(617) 638-8124
Fax
(617) 414-4953
NPI assigned
May 31, 2006
Last updated
Dec 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Dr. Gregory A. Grillone, M.D.NPI 1679535892
Title
President
Phone
(617) 638-7934

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X Primary

Addresses

Primary practice location

830 Harrison Ave
Suite 1400
Boston, MA 02118-2905

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118-2690

Other identifiers 2

IdentifierTypeStateIssuer
110071851AMedicaidMA
3115088MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040702001184 MA Part B Supplier - Clinic/Group Practice 2163409400 Receives reassigned benefits from 33 practitioners
Practice locations: Boston, MA

National Provider Directory

National Provider Directory

Locations

720 Harrison Ave
Ste 601
Boston, MA 02118
Phone (617) 414-1766

720 Harrison Ave
Ste D601
Boston, MA 02118

88 East Newton St
Ste D608
Boston, MA 02118

930 Commonwealth Ave
Fl 1
Boston, MA 02215
Phone (617) 414-6800

1200 Boylston St
Chestnut Hill, MA 02467
Phone (617) 566-3223

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1942257159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE",
            "address_2": "SUITE 1400",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905",
            "telephone_number": "617-638-8124",
            "fax_number": "617-414-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUMC OTOLARYNGOLOGIC FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "GRILLONE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-638-7934",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110071851A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3115088",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.