MARK WADE DICKINSON


Address: 388 Commonwealth Ave, Mgh Back Bay, Boston, MA 02215-2800
Phone: 6172677171

MARK WADE DICKINSON (NPI# 1154320059) 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) 1154320059
Entity Type Individual
Full Name MARK WADE DICKINSON
Credential MD
Practice Address 388 Commonwealth Ave
Mgh Back Bay
Boston
MA 02215-2800
Practice Telephone 6172677171
Practice Fax Number 6172622608
Mailing Telephone 6172677171
Mailing Fax Number 6172622608
Enumeration Date 2005-07-21
Last Update Date 2009-08-12
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 230380 MA Allopathic & Osteopathic Physicians
Y 208000000X Pediatrics 230380 MA Allopathic & Osteopathic Physicians
N 208M00000X Hospitalist 230380 MA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MA HPHC AA77715 01
MA FALLON 121680 01
MA MEDICARE PTAN GROUP 21241 OX2507 01
MA BCBS J41145 01
MA MEDICARE PTAN GROUP 21240 OX2506 01
MA 2128071 05
MA TUFTS 495561 01
MA NETWORK HEALTH 96009801 01
MA MASSHEALTH AA77715 01
MA CIGNA 3975642 01
MA AETNA 5035676 01

Other Providers MARK DICKINSON

NPI Name Taxonomy Address Enumeration
1457430464 Mark S Dickinson Optometrist 13190 Owens Way, Alpharetta, GA 30004-7357 2006-11-02
1124066055 Mark David Dickinson Dentist 4 Scott Dyer Rd, Cape Elizabeth, ME 04107-2017 2006-06-03
1215914239 Mark Thomas Dickinson Urology 11370 Anderson Street, Suite 1100, Loma Linda, CA 92354 2005-12-30

Office Location

Street Address 388 COMMONWEALTH AVE
MGH BACK BAY
City BOSTON
State MA
Zip Code 02215-2800

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982135257 Leah Wilson Nurse Practitioner 388 Commonwealth Ave, Boston, MA 02215-2800 2017-03-27
1376900050 Amir Mohsen Mahoozi Dmd, PC Health Maintenance Organization 388 Commonwealth Ave, Unit B-1, Boston, MA 02215-2800 2016-01-26
1679851695 Pooja K Khialani Student in an Organized Health Care Education/Training Program 388 Commonwealth Ave, Lower Level, Boston, MA 02215-2800 2011-07-25
1982892741 Mark Mizner, Dmd Dentist 388 Commonwealth Ave, Boston, MA 02215-2800 2007-10-05
1548389406 Joseph James Milavec Dentist 388 Commonwealth Ave, Office Suite #l3, Boston, MA 02215-2800 2007-03-29
1295875268 Robin R Cox Dentist 388 Commonwealth Ave, Unit B3, Boston, MA 02215-2800 2007-02-07
1184771065 Susan Hata Internal Medicine 388 Commonwealth Ave, Boston, MA 02215-2800 2007-01-04
1467471946 Mark Alan Mizner Dentist 388 Commonwealth Ave, Boston, MA 02215-2800 2006-07-18
1235192949 Edna C.a. Butaney Family Medicine 388 Commonwealth Ave, Unit B2, Boston, MA 02215-2800 2006-04-11
1750359477 Wei Lien Internal Medicine 388 Commonwealth Ave, Mgh Back Bay, Boston, MA 02215-2800 2006-03-09
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336746775 Lee T Gernon-lakin Physician Assistant 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 2020-10-08
1821695933 Matthew John Needham Student in an Organized Health Care Education/Training Program 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 2020-10-02
1114533866 Cdg Back Bay LLC Clinic/Center 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 2020-09-18
1619595105 Natasha Larocque Radiology 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 2020-07-10
1538783089 Yutsz Cherng Counselor 870r Commonwealth Avenue, Boston, MA 02215 2020-06-01
1306495924 Anthony Rosellini Psychologist 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 2019-09-06
1427605278 Liana Zucco Student in an Organized Health Care Education/Training Program Beth Israel Deaconess Medical Centre, Dept Anesthesia, 330 Brookline Ave, Ya-02q02, Boston, MA 02215 2019-08-26
1831759430 Brian William Hayes Radiology 330 Brookline Avenue, Beth Israel Deaconess Medical Cen, Boston, MA 02215 2019-06-17
1396304358 Elizabeth Hai Yen Du Student in an Organized Health Care Education/Training Program Beth Israel Deaconess Medical Center, Department of Rad, 330 Brookline Avenue, Boston, MA 02215 2019-06-12
1922665439 Corey Shaphard Miller Student in an Organized Health Care Education/Training Program 300 Brookline Avenue, Bidmc, Dana 501, Boston, MA 02215 2019-05-21
Find all providers in zip 02215

Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

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.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639790280 Allison Seats Pediatrics 265 Hyde Park Ave Apt 1rf, Boston, MA 02130-4222 2020-05-05
1154957132 Katherine Erin Douglas Pediatrics 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 2020-03-21
1346871381 Heather Mccaslin Kempczinski Pediatrics 360 Beacon St Apt 1, Boston, MA 02116-1063 2020-01-29
1083148167 Daniel Digiacomo Pediatrics 55 Fruit St # 165, Boston, MA 02114-2621 2017-04-17
1568814283 Jessica Leigh Dicarlo Pediatrics 800 Tufts Medical Center, Box 286, Department of Pediatrics, Boston, MA 02111-1651 2016-07-06
1336598598 Nicole Savina Rittershaus Pediatrics 354 Tremont Street, Boston, MA 02116 2016-06-08
1255793493 Kelsey A. Egan Pediatrics 840 Harrison Ave # Menino4, Boston, MA 02118-2905 2016-03-27
1851787626 Tierney Mancuso Morrison Pediatrics 300 Longwood Ave # 961, Boston, MA 02115-5724 2015-04-08
1710379797 Marleny Yordania Aquino Cabrera Pediatrics 725 Albany St Ste 8c, Boston, MA 02118-2526 2015-02-27
1558762203 Desiree Sierra Velez Pediatrics 32 Fruit St Fl 6, Boston, MA 02114-2620 2014-09-12
Find all providers in BOSTON

Competitor

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City BOSTON
Zip Code 02215

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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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