Individual provider Active NPI

Mark Khajag Markarian, MD, MSPH

  • Plastic and Reconstructive Surgery Physician
  • Wellesley, MA
National Provider Identifier
1174647192
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
255422 Issued in MA
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

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
LL1592OtherNVMEDICAL 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

LicenseStateTypeSpecialty
130523CAMDPlastic and Reconstructive Surgery Physician
255422MAMDPlastic and Reconstructive Surgery Physician

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.