Active NPI
Mark Howard Selesnick, MD
- Family Medicine Physician
- Pembroke, MA
National Provider Identifier
1285653147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 43914
- Practice address
- 28 Riverside Dr
Pembroke, MA 02359-4947 - Phone
- (781) 826-8065
- Fax
- (781) 826-8043
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 43914 | MA | Primary |
Addresses
Primary practice location
28 Riverside Dr
Pembroke, MA 02359-4947
Mailing address
28 Riverside Dr
Pembroke, MA 02359-4947
Phone (781) 826-8065
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312502400000",
"number": "1285653147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 RIVERSIDE DR",
"city": "PEMBROKE",
"state": "MA",
"postal_code": "023594947",
"telephone_number": "781-826-8065",
"fax_number": "781-826-8043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 RIVERSIDE DR",
"city": "PEMBROKE",
"state": "MA",
"postal_code": "023594947",
"telephone_number": "781-826-8065",
"fax_number": "781-826-8043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELESNICK",
"first_name": "MARK",
"middle_name": "HOWARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2011-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "43914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.