DR. MARK DAVID DEXTER


Address: 800 Washington St, Boston, MA 02111-1552
Phone: 6176368100

DR. MARK DAVID DEXTER (NPI# 1033408513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033408513
Entity Type Individual
Full Name DR. MARK DAVID DEXTER
Credential M.D.
Practice Address 800 Washington St
Boston
MA 02111-1552
Mailing Address Po Box 28302
New York
NY 10087-8302
Practice Telephone 6176368100
Practice Fax Number 6176368391
Mailing Telephone 6176365000
Enumeration Date 2011-04-05
Last Update Date 2020-04-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0203X Pediatrics
Specialization: Pediatric Critical Care Medicine
2014-00363 NC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC BCBS OF NC 19R6T 01
MA MA MEDICAL LICENSE 281842 01
NC 1033408513 05
MA 110158942A 05
NC LICENSE 2014-00363 01
MA MEDICARE S400622433 01
NC MEDICARE NCY4470322 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
2100 Stantonsburg Rd, Greenville, NC 278342818 2527445871 2527445759

Office Location

Street Address 800 WASHINGTON ST
City BOSTON
State MA
Zip Code 02111-1552

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306848643 Christopher B. Geary Orthopaedic Surgery 800 Washington St, Box 306, Boston, MA 02111-1552 2005-06-01
1720687767 Johnson Ching Pharmacist 800 Washington St, Boston, MA 02111-1552 2020-10-21
1174120075 Sarah Woodruff Nurse Practitioner 800 Washington St, Boston, MA 02111-1552 2020-10-04
1255946448 Tufts Medical Center Surgery 800 Washington St, Boston, MA 02111-1552 2020-09-14
1639784408 Pankaj Jain Internal Medicine 800 Washington St, Boston, MA 02111-1552 2020-09-09
1053926907 Arlind Decka Surgery 800 Washington St, Boston, MA 02111-1552 2020-09-08
1518571124 Abdulrahman Mohammad Alshiban Psychiatry & Neurology 800 Washington St, Boston, MA 02111-1552 2020-09-01
1922610229 Taylor Elizabeth Maffett Nurse Practitioner 800 Washington St, Boston, MA 02111-1552 2020-08-18
1467063685 Heather April Mills Tong Physical Therapist 800 Washington St, Boston, MA 02111-1552 2020-08-11
1245840032 Lindsey Holland Nurse Practitioner 800 Washington St, Boston, MA 02111-1552 2020-08-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689271397 Maximilian Richert Counselor 25 Kingston St, 4r, Boston, MA 02111 2020-10-06
1558978957 Tien-hsin Chang Student in an Organized Health Care Education/Training Program 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 2020-09-29
1548883465 Elizabeth Carter Stapleton Dentist Tufts School of Dental Medicine: Dept of Orthodontics, 1 Kneeland Street, Boston, MA 02111 2020-05-27
1932729597 Jacob Joseph Kosarchuk Neurological Surgery 800 Washington Street, Proger 7, Boston, MA 02111 2020-04-23
1164051868 Daniele Abela Surgery 860 Washington Street, South Building, 4th Floor, Boston, MA 02111 2020-04-04
1184265258 Jade Orthodontics Dentist 30 Kneeland St, Suite 301, Boston, MA 02111 2019-09-30
1932753639 Loukia Kamille Danaf Student in an Organized Health Care Education/Training Program 1 Kneeland Street, Tufts University School of Dental Me, Boston, MA 02111 2019-07-31
1033771944 Faris Khalifa Student in an Organized Health Care Education/Training Program 1 Kneeland Street, 5th Floor, Boston, MA 02111 2019-07-01
1609437276 Blair Hanna Ray Farbstein Student in an Organized Health Care Education/Training Program 1 Kneeland Street, 3rd Floor, Boston, MA 02111 2019-06-25
1821658709 Jennifer Drummond Internal Medicine 800 Washington St. Gme Office, Boston, MA 02111 2019-06-13
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Taxonomy Information

Taxonomy Code 2080P0203X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Critical Care Medicine

Taxonomy Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics)

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326699935 Colin Meyer-macaulay Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2019-09-25
1902303480 Haley Devries Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2018-04-10
1194272013 Cheuk Chung Au Pediatrics 300 Longwood Ave, Bader 634, Boston, MA 02115-5724 2016-09-08
1215378435 Peta-maree Ann Alexander Pediatrics Boston Children's Hospital, 300 Longwood Avenue, Cardiology Department, Boston, MA 02115 2013-07-16
1013352277 Sarah Elyse Hendrickson Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2013-05-01
1841556305 Jane Whitney Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2012-04-09
1891061768 Jennifer Ann Blumenthal Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2012-03-26
1679848782 Daniel Hames Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2012-03-22
1912297045 Ben D Albert Pediatrics 300 Longwood Ave, Bader 634 - Critical Care Medicine, Boston, MA 02115-5724 2011-04-11
1821397142 Diana Leslie Geisser Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2011-03-25
Find all providers in BOSTON

Competitor

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City BOSTON
Zip Code 02111

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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