MEDICARE: BENJAMIN HORN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207UN0901X	Nuclear Cardiology Physician	1013557	MA
2	207R00000X	Internal Medicine Physician	1013557	MA
3	207RC0000X	Cardiovascular Disease Physician	1013557	MA
4	207R00000X	Internal Medicine Physician	OS019927	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124471685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN HORN D.O.

Provider Business Mailing Address
First Line	:	960 MASSACHUSETTS AVE
Second Line	:	FL 2
City	:	BOSTON
State	:	MA
Zip	:	02118-2620
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 ROCHE BROTHERS WAY
Second Line	:	STE 110
City	:	NORTH EASTON
State	:	MA
Zip	:	02356-1000
Country	:	US
Telephone Number	:	781-792-6500
Fax Number	:	781-792-6501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2016
Last Update Date	:	05/18/2026

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Directions to “ BENJAMIN HORN D.O.” Practice Location

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