DR. STEPHEN TAKEO NISHIYAMA MD
NPI 1710978622
Pediatrics in Waltham, MA

Active since October 31, 2005PECOS EnrolledAccepts Medicare Assignment
40 SECOND AVE, STE 400, WALTHAM, MA 02451(781) 487-4340(781) 487-4341 Get Directions Write a Review

NPPES record last updated: January 3, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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

NPI1710978622
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. STEPHEN TAKEO NISHIYAMACredential: MD
Location Address40 SECOND AVE, STE 400Waltham, MA 02451
Mailing AddressPo Box 9142, Mass General Physician OrganizationCharlestown, MA 02129-9142 · (781) 487-4340 · Fax (781) 487-4341
Fax(781) 487-4341
Sole ProprietorNo
Medical School CMSUniversity Of Vermont College Of MedicineGraduated 1991
Enumeration DateOctober 31, 2005
Last NPPES UpdateJanuary 3, 2013
NPI 1710978622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License Licensed in MA · 81412
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.

40 SECOND AVE, Waltham, MA 02451

Other Identifiers 5

Medicare UPINF90470
OtherJ31669MA · Bcbs Ma
Medicaid3141683MA
Medicare PINA21821MA
Other081412MA · Tufts Health Plan

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID9436225091
PECOS Enrollment IDI20080904000521
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

New Patient
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Pediatrics
40 SECOND AVE, STE 400 MASS GENERAL MEDICAL GROUP WALTHAM
WALTHAM, MA 02451
Dermatology
40 SECOND AVE, MASS GENERAL WEST
WALTHAM, MA 02451
Anesthesiology
40 SECOND AVE
WALTHAM, MA 02451
Nurse Anesthetist, Certified Registered
40 SECOND AVE, SUITE 200
WALTHAM, MA 02451
Nurse Practitioner (Obstetrics & Gynecology)
40 SECOND AVE
WALTHAM, MA 02451
Nurse Practitioner (Pediatrics)
40 SECOND AVE, SUITE 340
WALTHAM, MA 02451
Internal Medicine
40 SECOND AVE, MASS GENERAL WEST
WALTHAM, MA 02451
Pediatrics (Pediatric Gastroenterology)
40 SECOND AVE, STE 340 MASS GENERAL WEST
WALTHAM, MA 02451

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710978622, enumerated as an "individual" on October 31, 2005.

The provider is located at 40 SECOND AVE STE 400 WALTHAM, MA 02451 and the phone number is (781) 487-4340.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare,. Please consult your insurance carrier or call the provider to verify.