Dr. Stephen Takeo Nishiyama
MD | Pediatrics | Male
Dr. Stephen Takeo Nishiyama, MD is a Waltham, Massachusetts based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Dr. Stephen Takeo Nishiyama is
40 Second Ave, Ste 400, Waltham, Massachusetts - 02451. He can be contacted on phone at
781-487-4340 and fax number 781-487-4341.
Dr. Stephen Takeo Nishiyama is a sole proprietor of his business.
NPI number (Unique professional ID) for Dr. Stephen Takeo Nishiyama is
1710978622 which was assigned by NPPES on 31 Oct, 2005 and it was last updated on 03 Jan, 2013.
Dr. Stephen Takeo Nishiyama license number is
81412 for Pediatrics (208000000X) in Massachusetts.
Dr. Stephen Takeo Nishiyama is a pediatrician who 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.
Complete Profile:
Dr. Stephen Takeo Nishiyama basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Dr. Stephen Takeo Nishiyama |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Dr. Stephen Takeo Nishiyama address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 40 Second Ave, Ste 400
Waltham, MA, 02451
United States |
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| Phone Number : | 781-487-4340 |
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| Fax Number : | 781-487-4341 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1710978622 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 31 Oct, 2005 |
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| Last Updated On : | 03 Jan, 2013 |
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Medicare Participation:
Dr. Stephen Takeo Nishiyama participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 9436225091 |
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| Medicare Enrollment ID : | I20080904000521 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | University Of Vermont College Of Medicine |
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| Graduation Year : | 1991 |
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| Accepts Medicare? | Yes. Dr. Stephen Takeo Nishiyama accepts medicare insurance. |
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Group Practice Association:
Dr. Stephen Takeo Nishiyama is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Stephen Takeo Nishiyama is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
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| Massachusetts General Physicians Organization Inc | 2466365820 | 2938 | 55 Fruit St
Boston, MA - 021142696
Ph: 6177240287 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Stephen Takeo Nishiyama are as mentioned. Primary taxonomy code for Dr. Stephen Takeo Nishiyama, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
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| 208000000X | Pediatrics | Yes | 81412 | MA |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Stephen Takeo Nishiyama such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| J31669 | Other | MA | BCBS MA |
| 3141683 | MEDICAID | MA | |
| 081412 | Other | MA | TUFTS HEALTH PLAN |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 9142, Mass General Physician Organization
Charlestown, MA, 02129-9142
United States |
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| Phone Number : | 781-487-4340 |
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| Fax Number : | 781-487-4341 |
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Business Location:
Patients can refer following map for directions to
Dr. Stephen Takeo Nishiyama practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.