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MARK WADE DICKINSON MD NPI 1154320059


NPI Information

NPI: 1154320059
Provider Name: MARK WADE DICKINSON, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
388 COMMONWEALTH AVE
MGH BACK BAY
BOSTON, MA
ZIP 02215
Phone: (617) 267-7171
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Mark Wade Dickinson, MD is a pediatrics in Boston, MA with 35 years of experience. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Mark Wade Dickinson, MD NPI is 1154320059. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

388 COMMONWEALTH AVE
MGH BACK BAY
BOSTON, MA
ZIP 02215-800
Phone: (617) 267-7171
Fax: (617) 262-2608

The NPI 1154320059 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Routine electrocardiogram (ekg) using at least 12 leads with interpretation and report (HCPCS:93010)
  • Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem (HCPCS:G0180)

The enumeration date for this NPI number is 7/21/2005 and was last updated on 8/12/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208M00000XHospitalist230380MASSACHUSETTSNo
2207R00000XInternal Medicine230380MASSACHUSETTSNo
3208000000XPediatrics230380MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1121680OTHERMASSACHUSETTSFALLON
23975642OTHERMASSACHUSETTSCIGNA
35035676OTHERMASSACHUSETTSAETNA
4OX2507OTHERMASSACHUSETTSMEDICARE PTAN GROUP 21241
52128071MEDICAIDMASSACHUSETTS
696009801OTHERMASSACHUSETTSNETWORK HEALTH
7495561OTHERMASSACHUSETTSTUFTS
8J41145OTHERMASSACHUSETTSBCBS
9A41092MEDICARE PIN
10OX2506OTHERMASSACHUSETTSMEDICARE PTAN GROUP 21240
11AA77715OTHERMASSACHUSETTSHPHC
12F50797MEDICARE UPIN
13AA77715OTHERMASSACHUSETTSMASSHEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.