Active NPI
Stuart J. Macdonald, D.M.D.
- General Practice Dentistry
- Hyde Park, MA
National Provider Identifier
1023134137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 20284
- Practice address
- 1259 Hyde Park Ave
Hyde Park, MA 02136-2817 - Phone
- (617) 364-5500
- Fax
- (617) 361-1351
- NPI assigned
- Mar 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 20284 | MA | Primary |
Addresses
Primary practice location
1259 Hyde Park Ave
Hyde Park, MA 02136-2817
Mailing address
195 Tower St
Dedham, MA 02026-3801
Phone (781) 381-0267
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160601000470 | MA | Order and Referring Only - Other (Non-Physician) | 5890085039 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462492800000",
"number": "1023134137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 TOWER ST",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020263801",
"telephone_number": "781-381-0267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1259 HYDE PARK AVE",
"city": "HYDE PARK",
"state": "MA",
"postal_code": "021362817",
"telephone_number": "617-364-5500",
"fax_number": "617-361-1351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONALD",
"first_name": "STUART",
"middle_name": "J.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-21",
"last_updated": "2016-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "20284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hyde Park, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.