Individual provider Active NPI

John A Marshall, D.M.D

  • Oral and Maxillofacial Pathology Dentistry
  • Fall River, MA
National Provider Identifier
1154331395
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
18730 Issued in MA
Practice address
180 Elsbree Street
Fall River, MA 02720
Phone
(508) 672-1069
Fax
(508) 672-3848
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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 Pathology Dentistry 1223P0106X 18730 MA Primary

Addresses

Primary practice location

180 Elsbree Street
Fall River, MA 02720

Mailing address

180 Elsbree Street
Fall River, MA 02720
Phone (508) 672-1069

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
I20061205000459 MA Practitioner - Oral Surgery 1658370481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Tufts University School of Dental Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dental Surgeons of Fall River PCGroup PAC ID 2567469018, 3 clinicians

Practice addresses (Care Compare)

180 Elsbree St
Fall River, MA 02720-7212
Phone (508) 672-1069

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18730MAMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Dental Surgeons of Fall River, PC Oral and Maxillofacial Pathology CurrentSince Aug 10, 2006 Accepting new patients

Locations

337 Linden St
Fall River, MA 02720
Phone (508) 567-1414

180 Elsbree St
Fall River, MA 02720
Phone (508) 672-1069

516 Hawthorn St
Ste 1
North Dartmouth, MA 02747
Phone (508) 992-0339

Interoperability endpoints

  • Direct secure messaging: jmarshall11188@direct.bmc.masshiway.net

Organizations & group practices 2

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1154331395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ELSBREE STREET",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02720",
            "telephone_number": "508-672-1069",
            "fax_number": "508-672-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ELSBREE STREET",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "02720",
            "telephone_number": "508-672-1069",
            "fax_number": "508-672-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MA",
            "license": "18730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.