NPIMap

Individual provider Active NPI

Max Jae Zeidenberg, PA-C

  • Surgical Physician Assistant
  • Boston, MA
National Provider Identifier
1396422648
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9489 Issued in MA
Practice address
725 Albany St Ste 4B
Boston, MA 02118-3549
Phone
(617) 638-5633
NPI assigned
Jun 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9489 MA Primary

Addresses

Primary practice location

725 Albany St Ste 4B
Boston, MA 02118-3549

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118-2690

Other practice location 1

39B District Ave
Dorchester, MA 02125
Phone (617) 638-7869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231024000574 MA Practitioner - Physician Assistant 0446606784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University Orthopaedic Surgical Associates IncGroup PAC ID 0143297655, 36 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-5633

725 Albany St
Boston, MA 02118-2526
Phone (617) 638-5633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Boston University Family Medicine, Inc. PastSince Sep 14, 2025 Accepting new patients
Brigham and Womens Physicians Organization Inc Past Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

75 Francis St
Boston, MA 02115

39B District Ave
Dorchester, MA 02125
Phone (617) 638-7869

Interoperability endpoints

  • Direct secure messaging: mzeidenberg259549@direct.bmc.masshiway.net
  • Direct secure messaging: zeidenberg.max.bwh@direct.partners.masshiway.net

Organizations & group practices 6

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1396422648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST STE 4B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183549",
            "telephone_number": "617-638-5633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39B District Ave",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "02125",
            "country_code": "US",
            "telephone_number": "617-638-7869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEIDENBERG",
        "first_name": "MAX",
        "middle_name": "JAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-29",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA9489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.