Dr Mark David Dexter, MD | |
300 Longwood Ave, Boston, MA 02115-5737 | |
(617) 355-6000 | |
Not Available |
Full Name | Dr Mark David Dexter |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Critical Care Medicine |
Location | 300 Longwood Ave, Boston, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033408513 | NPI | - | NPPES |
110158942A | Medicaid | MA | |
281842 | Other | MA | MA MEDICAL LICENSE |
S400622433 | Other | MA | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0203X | Pediatrics - Pediatric Critical Care Medicine | 281842 (Massachusetts) | Primary |
Entity Name | Chmc Anesthesia Foundation Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831268754 PECOS PAC ID: 0446155568 Enrollment ID: O20031203000162 |
Entity Name | Pratt Pediatric Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477590511 PECOS PAC ID: 3779475371 Enrollment ID: O20040329000127 |
Entity Name | Boston Childrens Heart Foundation Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982680922 PECOS PAC ID: 8729071675 Enrollment ID: O20040406001030 |
Entity Name | Children's Hospital Pediatric Associates, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457306664 PECOS PAC ID: 3476541830 Enrollment ID: O20040504000964 |
Entity Name | Chmc Anesthesia Foundation Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831268754 PECOS PAC ID: 0446155568 Enrollment ID: O20050920000649 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark David Dexter, MD 300 Longwood Ave, Boston, MA 02115-5737 Ph: (617) 355-6000 | Dr Mark David Dexter, MD 300 Longwood Ave, Boston, MA 02115-5737 Ph: (617) 355-6000 |
Puja Banka, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 Longwood Ave, Bader 203, Boston, MA 02115 Phone: 617-355-6363 | |
Angela M. Jacques, MD Pediatrics Medicare: Medicare Enrolled Practice Location: Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 Phone: 617-726-2066 | |
Dr. Elizabeth S Taglauer, M.D., PH.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Cailyn Hereen Rood, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Dr. Alon Peltz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Miki Nishitani, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Vickren Pillay, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 |