DR. DOUGLAS JAMES MATHISEN MD
NPI 1699759019
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Boston, MA

Q: What is Douglas Mathisen's NPI number?

The NPI number for Douglas Mathisen is 1699759019. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Q: What is Douglas Mathisen's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Q: When was this NPI record last updated?

The NPPES record for Douglas Mathisen was last updated on November 21, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 November 30, 2005PECOS Enrolled

55 FRUIT STREET, BLK 1570 THORACIC SURGERY DEPARTMENT, BOSTON, MA 02114(617) 726-6826(617) 726-7667 Get Directions Write a Review

NPPES record last updated: November 21, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Douglas James Mathisen Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOUGLAS JAMES MATHISEN MD (NPI 1699759019) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Boston, Massachusetts, licensed in Massachusetts (39784) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699759019

Entity TypeIndividualMale

Primary Taxonomy208G00000X

Provider Legal NameDR. DOUGLAS JAMES MATHISENCredential: MD

Location Address55 FRUIT STREET, BLK 1570 THORACIC SURGERY DEPARTMENTBoston, MA 02114-2696

Mailing AddressPo Box 9142, Mass General Physician OrganizationCharlestown, MA 02129-9142 · (671) 726-6826 · Fax (617) 726-7667

Phone(617) 726-6826

Fax(617) 726-7667

Sole ProprietorNo

Enumeration DateNovember 30, 2005

Last NPPES UpdateNovember 21, 2012

✔ NPI 1699759019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians

Taxonomy Code208G00000X

License✔ Licensed in MA · 39784

Definition

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

55 FRUIT STREET, Boston, MA 02114

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Other Identifiers 5

Other710067MA · Tufts Health Plan

Medicare ID-Type UnspecifiedE05949MA

OtherE05949MA · Bcbs Ma

Medicaid0182656MA

Medicare UPINB73886

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Douglas James Mathisen Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02114 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

$189.86 typical visit price

range $63.72 – $189.86

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

Most-billed visit code 99205

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

Most-billed visit code 99213

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

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.

KUI TOH GERARD LEONG M.D.

Internal Medicine (Cardiovascular Disease)

55 FRUIT STREET, MASSACHUSETTS GENERAL HOSPITAL
BOSTON, MA 02114

Suffolk County (617) 726-8862

MS. JACQUELINE BANGO LICSW

Social Worker (Clinical)

55 FRUIT STREET, FOUNDERS BUILDING SUITE 880
BOSTON, MA 02114

Suffolk County (617) 643-8281

SARA ELIZABETH GROSSLEIN PA

Physician Assistant

55 FRUIT STREET, WHITE 1
BOSTON, MA 02114

Suffolk County (617) 724-4100

JEFFREY M ELLENBOGEN M.D.

Psychiatry & Neurology (Neurology)

55 FRUIT STREET, WANG 720 (NEUROLOGY)
BOSTON, MA 02114

Suffolk County (617) 724-7419

DR. NANCY LEE HARRIS MD

Pathology (Anatomic Pathology & Clinical Pathology)

55 FRUIT STREET, WRN 2 PATHOLOGY ASSOCIATES
BOSTON, MA 02114

Suffolk County (617) 726-5155

DR. STANLEY YANG SHAW MD PHD

Internal Medicine (Cardiovascular Disease)

55 FRUIT STREET, YAW 5 CARDIAC UNIT ASSOCIATES
BOSTON, MA 02114

Suffolk County (617) 724-6750

LEONARDO V RIELLA M.D., PHD

Internal Medicine

55 FRUIT STREET, WHITE 5
BOSTON, MA 02114

Suffolk County (617) 726-5050

SUSAN MAHER CRNA

Nurse Anesthetist, Certified Registered

55 FRUIT STREET, CLN 309 MGH ANESTHESIA ASSOCIATES
BOSTON, MA 02114

Suffolk County (617) 726-3030

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 Douglas Mathisen's NPI number?

The NPI number for Douglas Mathisen is 1699759019. It was assigned to this individual provider in the NPPES registry on November 30, 2005.

Where is Douglas Mathisen located?

Douglas Mathisen practices at 55 Fruit Street Blk 1570 Thoracic Surgery Department, Boston, MA 02114. The listed phone number is (617) 726-6826.

What is Douglas Mathisen's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Douglas Mathisen enrolled in Medicare?

Yes. Douglas Mathisen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Douglas Mathisen was last updated on November 21, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.