PHILIP FORMICA MD
NPI 1184883209
Internal Medicine - Advanced Heart Failure and Transplant Cardiology in Burlington, MA
About Philip Formica Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PHILIP FORMICA MD (NPI 1184883209) is an individual advanced heart failure and transplant cardiology provider in Burlington, Massachusetts, licensed in Massachusetts (256905) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Northeast Hospital Corporation, and is a graduate of Other (2006).
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Philip Formica Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
5Medicare enrollment records show Philip Formica reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Burlington, MA 01805
- Reassigned Medicare billing, Massachusetts enrollment
- 410 clinicians in this Medicare group
Burlington, MA 01805
- Reassigned Medicare billing, Massachusetts enrollment
- Also billed through NPI 1063447316 (Massachusetts)
- 1,574 clinicians in this Medicare group
Boston, MA 02215
- Reassigned Medicare billing, Massachusetts enrollment
- 2,579 clinicians in this Medicare group
Fall River, MA 02720
- Reassigned Medicare billing, Massachusetts enrollment
- 163 clinicians in this Medicare group
Fairhaven, MA 02719
- Reassigned Medicare billing, Massachusetts enrollment
- 1,144 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 25
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northeast Hospital Corporation
Acute Care Hospitals · Beverly, MAEmerson Hospital -
Acute Care Hospitals · W Concord, MABeth Israel Deaconess Medical Center
Acute Care Hospitals · Boston, MAWinchester Hospital
Acute Care Hospitals · Winchester, MALahey Hospital & Medical Center, Burlington
Acute Care Hospitals · Burlington, MAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 01805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BURLINGTON, MA 01805
BURLINGTON, MA 01805
BURLINGTON, MA 01805
BURLINGTON, MA 01805
BURLINGTON, MA 01805
BURLINGTON, MA 01805
BURLINGTON, MA 01805
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Philip Formica's NPI number?
The NPI number for Philip Formica is 1184883209. It was assigned to this individual provider in the NPPES registry on June 4, 2008.
Where is Philip Formica located?
Philip Formica practices at 41 Mall Road Lahey Hospital And Medical Center, Burlington, MA 01805. The listed phone number is (781) 744-8460.
What is Philip Formica's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Advanced Heart Failure and Transplant Cardiology, with taxonomy code 207RA0001X.
Is Philip Formica enrolled in Medicare?
Yes. Philip Formica is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Philip Formica's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Philip Formica reassigns Medicare benefits to 5 organizations: Beth Israel Lahey Health Primary Care, Inc. (Burlington, MA), Lahey Clinic, Inc. (Burlington, MA), Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc (Boston, MA), Southcoast Hospitals Group, Inc (Fall River, MA) and Southcoast Physicians Group, Inc. (Fairhaven, MA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Philip Formica's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Philip Formica accept?
Health plans from Anthem Blue Cross and Blue Shield and Taro Health list Philip Formica as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Philip Formica affiliated with any hospitals?
According to CMS data, Philip Formica is affiliated with Northeast Hospital Corporation, Emerson Hospital -, Beth Israel Deaconess Medical Center, Winchester Hospital and Lahey Hospital & Medical Center, Burlington.
When was this NPI record last updated?
The NPPES record for Philip Formica was last updated on April 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Philip Formica, MD · NPI 1184883209
Advanced Heart Failure and Transplant Cardiology physician in Burlington, Massachusetts. Individual provider, active in the CMS NPPES registry since June 4, 2008.
## Identity
- **NPI:** 1184883209 (Entity type: Individual)
- **Enumerated:** June 4, 2008
- **Primary specialty:** Internal Medicine - Advanced Heart Failure and Transplant Cardiology · taxonomy 207RA0001X
- **State license:** 256905 (Massachusetts)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTER, Burlington, MA 01805-0001
- **Phone:** (781) 744-8460 · **Fax:** (781) 744-5261
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Beth Israel Lahey Health Primary Care, Inc. (NPI 1043710791, Burlington, MA); Lahey Clinic, Inc. (NPI 1538194980, Burlington, MA); Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc (NPI 1194765438, Boston, MA); Southcoast Hospitals Group, Inc (NPI 1306871223, Fall River, MA); Southcoast Physicians Group, Inc. (NPI 1861830143, Fairhaven, MA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2006
## Record status
- **NPPES last updated:** April 25, 2019
- **Other identifiers:** Medicaid 110097738A (MA)
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Source: [NPI Profile](https://npiprofile.com/npi/1184883209) · Data from the CMS NPPES public registry.