Individual provider Active NPI

Marcin Jarmoc, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Boston, MA
National Provider Identifier
1033388228
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
9499 LIMITED LICENSE Issued in MA
Practice address
1 Kneeland St
5TH Floor, Oral and Maxillofacial Surgery
Boston, MA 02111-1527
Phone
(617) 636-6516
NPI assigned
Feb 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 9499 LIMITED LICENSE MA Primary

Addresses

Primary practice location

1 Kneeland St
5TH Floor, Oral and Maxillofacial Surgery
Boston, MA 02111-1527

Mailing address

1 Kneeland St
5TH Floor, Oral and Maxillofacial Surgery
Boston, MA 02111-1527
Phone (617) 636-6516

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160105000586 MA Practitioner - Oral Surgery 3577865831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Northern Essex Oral Surgery Assoc IncGroup PAC ID 2264592203, 2 clinicians

Practice addresses (Care Compare)

390 Water St
Haverhill, MA 01830-6476
Phone (978) 374-7451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9499 LIMITED LICENSEMAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Essex Oral Surgery Assoc Inc Oral and Maxillofacial Surgery CurrentSince Dec 31, 2015 Accepting new patients

Locations

390 Water St
Haverhill, MA 01830
Phone (978) 374-7451

Interoperability endpoints

  • Direct secure messaging: mjarmoc29778@tuftsmedicine.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1033388228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "address_2": "5TH FLOOR, ORAL AND MAXILLOFACIAL SURGERY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "address_2": "5TH FLOOR, ORAL AND MAXILLOFACIAL SURGERY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARMOC",
        "first_name": "MARCIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "9499 LIMITED LICENSE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.