Individual provider Active NPI

Maryam Akbari, D.M.D, M.P.H, M.D

  • Surgery Physician
  • Watertown, MA
National Provider Identifier
1083091664
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
312294 Issued in NY
Practice address
49 Edgecliff Rd
Watertown, MA 02472-3545
Phone
(617) 866-8672
NPI assigned
May 2, 2015
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS040260 PA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 062309 NY
Surgery Physician 208600000X 312294 NY Primary

Addresses

Primary practice location

49 Edgecliff Rd
Watertown, MA 02472-3545

Mailing address

49 Edgecliff Rd
Watertown, MA 02472-3545
Phone (617) 866-8672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211116000128 NY Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 5597001776 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DS040260PAMDDentist
062309NYMDOral and Maxillofacial Surgery (Dentist)
312294NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Dec 21, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery CurrentSince Sep 6, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 6, 2025 Accepting new patients
New York City Health and Hospitals Corporation Oral and Maxillofacial Surgery Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-4951

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1083091664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 EDGECLIFF RD",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024723545",
            "telephone_number": "617-866-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 EDGECLIFF RD",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024723545",
            "telephone_number": "617-866-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKBARI",
        "first_name": "MARYAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D, M.P.H, M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-02",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040260",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "062309",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "312294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

Verify at the official NPI Registry.