DR. STEPHEN TAKEO NISHIYAMA MD
NPI 1710978622
Pediatrics in Waltham, MA
About Dr. Stephen Takeo Nishiyama Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. STEPHEN TAKEO NISHIYAMA MD (NPI 1710978622) is an individual pediatrics provider in Waltham, Massachusetts, licensed in Massachusetts (81412) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and is a graduate of University Of Vermont College Of Medicine (1991).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 5
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Stephen Takeo Nishiyama Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Stephen Nishiyama reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Boston, MA 02114
- Reassigned Medicare billing, Massachusetts enrollment
- 6,360 clinicians in this Medicare group
Boston, MA 02114
- Reassigned Medicare billing, Massachusetts enrollment
- 6,234 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02451 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WALTHAM, MA 02451
WALTHAM, MA 02451
WALTHAM, MA 02451
WALTHAM, MA 02451
WALTHAM, MA 02451
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stephen Nishiyama's NPI number?
The NPI number for Stephen Nishiyama is 1710978622. It was assigned to this individual provider in the NPPES registry on October 31, 2005.
Where is Stephen Nishiyama located?
Stephen Nishiyama practices at 40 Second Ave Ste 400, Waltham, MA 02451. The listed phone number is (781) 487-4340.
What is Stephen Nishiyama's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Stephen Nishiyama enrolled in Medicare?
Yes. Stephen Nishiyama is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Stephen Nishiyama's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stephen Nishiyama reassigns Medicare benefits to 2 organizations: Massachusetts General Physicians Organization Inc (Boston, MA) and The General Hospital Corporation (Boston, MA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stephen Nishiyama's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Stephen Nishiyama was last updated on January 3, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Stephen Takeo Nishiyama, MD · NPI 1710978622
Pediatrics physician in Waltham, Massachusetts. Individual provider, active in the CMS NPPES registry since October 31, 2005.
## Identity
- **NPI:** 1710978622 (Entity type: Individual)
- **Enumerated:** October 31, 2005
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 81412 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 40 SECOND AVE, STE 400, Waltham, MA 02451
- **Phone:** (781) 487-4340 · **Fax:** (781) 487-4341
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Massachusetts General Physicians Organization Inc (NPI 1801874573, Boston, MA); The General Hospital Corporation (NPI 1023049236, Boston, MA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Vermont College Of Medicine, class of 1991
## Record status
- **NPPES last updated:** January 3, 2013
- **Other identifiers:** Medicare UPIN F90470; Other J31669 (MA); Medicaid 3141683 (MA); and 2 more
---
Source: [NPI Profile](https://npiprofile.com/npi/1710978622) · Data from the CMS NPPES public registry.