Edward Vanisky, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DN22199 Issued in MA

Practice address

77 S Bedford St
Suite 100
Burlington, MA 01803-5115

Phone

(781) 272-0800

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Oral Surgery

Education

Temple University School of Medicine, 1997

Medicare assignment

May accept Medicare assignment

Group practices

Burlington Oral and Facial Surgery Center LLCGroup PAC ID 2264656859, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Burlington Oral and Facial Surgery Center LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Burlington, MA
  • NPI 1003251398
  Medicare reassignment Care Compare group
• Commonwealth Oral & Maxillofacial Surgical Associates Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Cambridge, MA
  • NPI 1457375107
  NPD
• University of Vermont Medical Center Inc

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1184609018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 S BEDFORD ST STE 100",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018035154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 S BEDFORD ST",
            "address_2": "SUITE 100",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018035115",
            "telephone_number": "781-272-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANISKY",
        "first_name": "EDWARD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS030512L",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN22199",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MA",
            "license": "DN22199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camelia Valhuerdi Porto, MD
• Jessica Valley, PA-C
• Valor Counseling and Consultation Services, LLC
• Stephanie J Vamos, PA-C
• Amanda Van Auken
• Alex J Vanni, M.D.
• Janice Power Vanwart, A.P.R.N.
• Laleh Taheri Varasteh, RPH, MSF
• Daniel Vardeh, M.D.
• Dirk Johannes Varelmann, M.D.

• Oral & Maxillofacial Surgery (D.M.D.) in Burlington, MA
• Providers in Burlington, MA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.