Active NPI
Mark Khajag Markarian, MD, MSPH
- Plastic and Reconstructive Surgery Physician
- Wellesley, MA
National Provider Identifier
1174647192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 255422
- Practice address
- 25 Walnut St
Suite 400
Wellesley, MA 02481-2152 - Phone
- (781) 431-0002
- Fax
- (781) 237-2022
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 255422 | MA | Primary |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 130523 | CA |
Addresses
Primary practice location
25 Walnut St
Suite 400
Wellesley, MA 02481-2152
Mailing address
14847 Hayward St
Whittier, CA 90603-2048
Phone (706) 495-7886
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LL1592 | Other | NV | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130523 | CA | MD | Plastic and Reconstructive Surgery Physician |
| 255422 | MA | MD | Plastic and Reconstructive Surgery Physician |
Interoperability endpoints
- mmarkarian35378@direct.bilh.masshiway.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1174647192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14847 HAYWARD ST",
"city": "WHITTIER",
"state": "CA",
"postal_code": "906032048",
"telephone_number": "706-495-7886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 WALNUT ST",
"address_2": "SUITE 400",
"city": "WELLESLEY",
"state": "MA",
"postal_code": "024812152",
"telephone_number": "781-431-0002",
"fax_number": "781-237-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKARIAN",
"first_name": "MARK",
"middle_name": "KHAJAG",
"name_prefix": "Dr.",
"credential": "MD, MSPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "MA",
"license": "255422",
"primary": true
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "CA",
"license": "130523",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "LL1592",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wellesley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.