MEDICARE: DR. GEORGE TOLIS JR. M.D.

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	208600000X	Surgery Physician	230131	MA
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	224934	NY

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

General Provider Information

NPI Number	:	1841272283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE TOLIS JR. M.D.

Provider Business Mailing Address
First Line	:	960 MASSACHUSETTS AVENUE
Second Line	:	FL 2
City	:	BOSTON
State	:	MA
Zip	:	02118-2690
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 FRUIT ST
Second Line	:	COX 6 SUITE 630
City	:	BOSTON
State	:	MA
Zip	:	02114-2621
Country	:	US
Telephone Number	:	617-643-9280
Fax Number	:	617-726-5804

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	03/16/2026

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