PHILIP FORMICA MD
NPI 1184883209
Internal Medicine - Advanced Heart Failure and Transplant Cardiology in Burlington, MA

Q: 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.

Q: 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.

Q: 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.

Active since June 04, 2008PECOS EnrolledAccepts Medicare Assignment

41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTER, BURLINGTON, MA 01805(781) 744-8460(781) 744-5261 Get Directions Write a Review

NPPES record last updated: April 25, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 25, 2019, Sep 13, 2018, Feb 11, 2016 (3 updates tracked since 2016).

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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

NPI1184883209

Entity TypeIndividualMale

Primary Taxonomy207RA0001X

Provider Legal NamePHILIP FORMICACredential: MD

Location Address41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTERBurlington, MA 01805-0001

Mailing Address41 Mall Road, Lahey Hospital And Medical CenterBurlington, MA 01805-0001 · (781) 744-8460 · Fax (781) 744-5261

Phone(781) 744-8460

Fax(781) 744-5261

Sole ProprietorYes

Medical School CMSOtherGraduated 2006

Enumeration DateJune 4, 2008

Last NPPES UpdateApril 25, 20193 updates tracked since enumeration

✔ NPI 1184883209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Advanced Heart Failure and Transplant CardiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RA0001X

License✔ Licensed in MA · 256905

Definition

Specialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced heart failure across the spectrum from consideration for high-risk cardiac surgery, cardiac transplantation, or mechanical circulatory support, to pre-and post-operative evaluation and management of patients with cardiac transplants and mechanical support devices, and end-of-life care for patients with end-stage heart failure.

Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 256905 (MA)

Also ListedNuclear Medicine · Nuclear CardiologyTaxonomy 207UN0901X · License 256905 (MA)

41 MALL ROAD, Burlington, MA 01805

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Other Identifiers 1

Medicaid110097738AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID2668607243

PECOS Enrollment IDI20131107000707

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

577 services512 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

309 services308 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

301 services195 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

277 services136 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

252 services211 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

183 services171 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

80 services79 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

75 services75 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

75 services75 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

62 services53 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

56 services56 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

39 services38 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

39 services30 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

38 services21 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

36 services36 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

35 services35 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

31 services31 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

27 services27 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

27 services27 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

26 services20 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

24 services20 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional 93228

16 services16 patients

Heart rhythm recording of continous external ekg over 8-15 days 93246

A heart rhythm recording is a non-invasive procedure where a small device, attached externally, monitors your heart's electrical activity for 8-15 days. It helps detect irregular heart rhythms, assess heart rate, and guide treatment decisions. It's safe, painless, and can be done during normal daily activities.

14 services13 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days 93248

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

14 services13 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

12 services12 patients

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, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220033

Location85 Herrick StreetBeverly, MA 01915 · Essex County

Emergency services Birthing friendly

Emerson Hospital -

Acute Care Hospitals · W Concord, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220084

Location133 Old Road To 9 Acre CornerW Concord, MA 01742 · Middlesex County

Emergency services Birthing friendly

Beth Israel Deaconess Medical Center

Acute Care Hospitals · Boston, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220086

Location330 Brookline AvenueBoston, MA 02215 · Suffolk County

Emergency services Birthing friendly

Winchester Hospital

Acute Care Hospitals · Winchester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220105

Location41 Highland AvenueWinchester, MA 01890 · Middlesex County

Emergency services Birthing friendly

Lahey Hospital & Medical Center, Burlington

Acute Care Hospitals · Burlington, MA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220171

Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County

Emergency services

Physician 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.

New Patient

$144.11 typical visit price

range $63.72 – $189.86

Typical copayment $36.02 (range $15.93 – $47.46)

Most-billed visit code 99204

Established Patient

$111.18 typical visit price

range $21.07 – $155.29

Typical copayment $27.79 (range $5.26 – $38.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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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.

TEMITOPE PATRICIA AWOSOGBA M.D.

Obstetrics & Gynecology

41 MALL ROAD
BURLINGTON, MA 01805

Middlesex County (781) 744-8560

ERIC SCOTT KERNS MD

Internal Medicine (Nephrology)

41 MALL ROAD, LAHEY HOSPITAL & MEDICAL CENTER
BURLINGTON, MA 01805

Middlesex County (781) 744-8430

DR. JONATHAN RASSI M.D.

Radiology (Diagnostic Radiology)

41 MALL ROAD, LAHEY HOSPITAL & MEDICAL CENTER
BURLINGTON, MA 01805

Middlesex County (781) 744-8170

MS. ANNE MARCIA WOODBURY MSN, CRNA

Nurse Anesthetist, Certified Registered

41 MALL ROAD
BURLINGTON, MA 01805

Middlesex County (817) 744-8132

DR. CARMI SANTOS PUNZALAN M.D.

Internal Medicine (Gastroenterology)

41 MALL ROAD, LAHEY HOSPITAL & MEDICAL CENTER
BURLINGTON, MA 01805

Middlesex County (781) 744-8000

RUTH ELIZABETH MEDINA GUTIERREZ MD

Hospitalist

41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON, MA 01805

Middlesex County (781) 744-3839

BRITTNEY CHRISTINA LOCKE PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)

41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON, MA 01805

Middlesex County (781) 744-8610

LINDA ROSE CARUSO

Nurse Practitioner (Family)

41 MALL ROAD, LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON, MA 01805

Middlesex County (781) 744-8570

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.

What insurance does Philip Formica accept?

Health plans from Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield 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.