Individual provider Active NPI

Mark A Lerman, DMD

  • Oral and Maxillofacial Pathology Dentistry
  • Boston, MA
National Provider Identifier
1295819217
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
21698 Issued in MA
Practice address
1 Kneeland St RM 646
Boston, MA 02111-1527
Phone
(617) 636-6510
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 21698 MA
Oral and Maxillofacial Pathology Dentistry 1223P0106X 21698 MA Primary

Addresses

Primary practice location

1 Kneeland St RM 646
Boston, MA 02111-1527

Mailing address

1 Kneeland St RM 646
Boston, MA 02111-1527
Phone (617) 636-6510

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-7001

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
I20061117000111 MA Practitioner - Oral and Maxillofacial PathologyPractitioner - Oral Surgery 6507864030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral and Maxillofacial Pathology
Education
Tufts University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Tufts CollegeGroup PAC ID 3779522628, 15 clinicians

Practice addresses (Care Compare)

1 Kneeland St
Boston, MA 02111-1527
Phone (617) 636-6828

200 Harrison Ave
2CD Floor
Boston, MA 02111-1527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21698MAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Tufts College CurrentSince Aug 1, 2014 Accepting new patients

Locations

1 Kneeland St
#646
Boston, MA 02111
Phone (617) 636-6510

1 Kneeland St
Boston, MA 02111
Phone (617) 636-6515

1 Kneeland St
Fl 6
Boston, MA 02111
Phone (617) 636-3932

1 Kneeland St
Rm 646
Boston, MA 02111
Phone (617) 636-6510

Organizations & group practices 1

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1295819217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST RM 646",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST RM 646",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-7001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LERMAN",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "21698",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MA",
            "license": "21698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.