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DR. MARK NISSENBAUM DMD MDC FCDSA OMFS
NPI 1902897184
Oral & Maxillofacial Surgery in Chestnut Hill, MA

Active since November 04, 2005PECOS EnrolledAccepts Medicare Assignment
200 BOYLSTON ST, SUITE 305, CHESTNUT HILL, MA 02467(617) 731-8888(617) 731-3107 Get Directions Write a Review

NPPES record last updated: February 27, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Mark Nissenbaum Dmd Mdc Fcdsa Omfs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK NISSENBAUM DMD MDC FCDSA OMFS (NPI 1902897184) is an individual oral & maxillofacial surgery provider in Chestnut Hill, Massachusetts, licensed in Massachusetts (8460) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1902897184
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. MARK NISSENBAUMCredential: DMD MDC FCDSA OMFS
Location Address200 BOYLSTON ST, SUITE 305Chestnut Hill, MA 02467-2012
Mailing Address200 Boylston St, Suite 305Chestnut Hill, MA 02467-2012 · (617) 731-8888 · Fax (617) 731-3107
Phone(617) 731-8888
Fax(617) 731-3107
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateNovember 4, 2005
Last NPPES UpdateFebruary 27, 2014
✔ NPI 1902897184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in MA · 8460
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
200 BOYLSTON ST, Chestnut Hill, MA 02467
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana and more.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. Mark Nissenbaum Dmd Mdc Fcdsa Omfs 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 ID547273989
PECOS Enrollment IDI20060801000181
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
15 services15 patients

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIELLE NUGENT PT, DPT
Physical Medicine & Rehabilitation
200 BOYLSTON ST
CHESTNUT HILL, MA 02467
Norfolk County (617) 754-9100
MS. CHRISTINA DUPRE M.S., C.G.C.
Genetic Counselor, MS
200 BOYLSTON ST, SUITE 301
CHESTNUT HILL, MA 02467
Norfolk County (617) 731-3400
MERLE ELLEN MONSEIN MD
Obstetrics & Gynecology
200 BOYLSTON ST, SUITE 301 NEW ENGLAND OB GYN ASSOCIATES
CHESTNUT HILL, MA 02467
Norfolk County (617) 731-3400
DR. JEFFREY E SILVER MD
Specialist
200 BOYLSTON ST, SUITE 303
CHESTNUT HILL, MA 02467
Norfolk County (617) 332-0401
ZACH WEHMEYER RDN
Dietitian, Registered
200 BOYLSTON ST
CHESTNUT HILL, MA 02467
Norfolk County (617) 277-5000
AMELIA NODELL PT, DPT
Physical Therapist (Orthopedic)
200 BOYLSTON ST
CHESTNUT HILL, MA 02467
Norfolk County (617) 754-9100
CHESTNUT HILL PLASTIC AND AESTHETIC SURGERY ASSOCIATES, LLC
Surgery (Plastic and Reconstructive Surgery)
200 BOYLSTON ST, SUITE # 307
CHESTNUT HILL, MA 02467
Norfolk County (617) 558-7010
BETH ISRAEL DEACONESS MEDICAL CENTER, INC
Clinic/Center (Urgent Care)
200 BOYLSTON ST
CHESTNUT HILL, MA 02467
Norfolk County (617) 667-7000

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 Mark Nissenbaum's NPI number?

The NPI number for Mark Nissenbaum is 1902897184. It was assigned to this individual provider in the NPPES registry on November 4, 2005.

Where is Mark Nissenbaum located?

Mark Nissenbaum practices at 200 Boylston St Suite 305, Chestnut Hill, MA 02467. The listed phone number is (617) 731-8888.

What is Mark Nissenbaum's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Mark Nissenbaum enrolled in Medicare?

Yes. Mark Nissenbaum 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.

What insurance does Mark Nissenbaum accept?

Health plans from Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Mark Nissenbaum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Nissenbaum was last updated on February 27, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.