DR. LAURIE M DOUGLASS (MD) – Neurology with Special Qualifications in Child Neurology Physician, NPI 1124017975

DR. LAURIE M DOUGLASS (MD) is a healthcare provider. based in Boston, Massachusetts. specializing in NEUROLOGY, PEDIATRIC MEDICINE. They hold the professional credentials MD. They hold a License No. 159823 (MA). The NPI Number for DR. LAURIE M DOUGLASS (MD) is 1124017975

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
DR. LAURIE M DOUGLASS (MD)
NPI
1124017975
Phone
Not provided
Address
720 HARRISON AVE
Enumeration Date
14 October 2005
Last Update Date
28 October 2020

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
61741448413
Graduation Year
1994 (32 years ago)
PAC ID
5294799433
Group Practice PAC ID
1557263340
Professional Enrollment ID
I20041117000217
Address ID
MA021182526BO725XXSTXX300
Telehealth
Yes

Contacts

Secure Messaging
ldouglass246789@UmassMemorial.direct-ci.com
FHIR Endpoint
https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

1,144 NEUROLOGY in MA

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Provider Addresses for DR. LAURIE M DOUGLASS (MD)

  • Doctors Office Building, 720, Harrison Avenue, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    DOB 503

    BOSTON, MA 021182371

    Phone:

    Type: Mailing

  • Shapiro Center, 725, Albany Street, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    SHAPIRO 8

    BOSTON, MA 021182526

    Phone: (617) 414-4841

    Fax: (617) 414-4502

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $73.

Total Amount is formed as General ($73) + Research ($0) + Ownership ($0) = $73.

Last reported payment date: 2024-12-07 • Largest payer in this snapshot: SK Life Science, Inc. ($73).

Total Amount

$73

General + Research + Ownership

Payments

1

Total payment records

General Amount

$73

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-07

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
SK Life Science, Inc.$73
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-11-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041117000217INeurologyMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02118)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557263340View full group profile
NameSpecialtyState
-MA
Pediatric Medicine, GastroenterologyMA
-MA
Pediatric MedicineMA
-MA
Neurology, Pediatric MedicineMA
Pediatric MedicineMA
Pediatric MedicineMA
Neurology, Pediatric MedicineMA
-MA

Reviews

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Frequently asked questions

Is there an official ID for DR. LAURIE M DOUGLASS (MD) in U.S. healthcare records?
The official identifier for DR. LAURIE M DOUGLASS (MD) is NPI 1124017975.
Is DR. LAURIE M DOUGLASS (MD) still an active registrant?
DR. LAURIE M DOUGLASS (MD) carries an active NPI according to the public dataset.
What kind of doctor is DR. LAURIE M DOUGLASS (MD)?
DR. LAURIE M DOUGLASS (MD) is associated with Neurology with Special Qualifications in Child Neurology Physician in the directory — Clinical services aligned with this taxonomy classification.
Is DR. LAURIE M DOUGLASS (MD) located near Boston?
DR. LAURIE M DOUGLASS (MD) currently maps to Boston, Massachusetts in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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