Active NPI
Mark S Siskind, MD
- Nephrology Physician
- Fall River, MA
National Provider Identifier
1508840612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 8373
- Practice address
- 277 Pleasant St
Ste 305
Fall River, MA 02721-3005 - Phone
- (401) 438-5950
- Fax
- (401) 435-2561
- NPI assigned
- Dec 1, 2005
- Last updated
- Oct 4, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 53848 | MA | |
| Nephrology Physician | 207RN0300X | 8373 | RI | Primary |
Addresses
Primary practice location
277 Pleasant St
Ste 305
Fall River, MA 02721-3005
Mailing address
318 Waterman Ave
East Providence, RI 02914
Phone (401) 438-5950
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8373 | Other | RI | BLUE CROSS |
| 10137MIR | Other | HARVARD PILGRIM | |
| 000000033673 | Other | MA | BOSTON MEDICAL |
| 39004908 | Other | RAILROAD MEDICARE | |
| 1488 | Other | NEIGHBORHOOD | |
| 782413 | Other | AETNA | |
| J30013 | Other | MA | BLUE CROSS |
| 6198023 | Medicaid | MA | |
| 008373 | Other | TUFTS | |
| 0702100003 | Other | CIGNA | |
| 3100129 | Other | UNITED | |
| 7003280 | Medicaid | RI | |
| 004616 | Other | RI | BLUE CHIP |
| 3110893 | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8373 | RI | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prima Care, PC | Past | Accepting new patients | |
| Prima Care, PC | Past | Accepting new patients | |
| Fall River Nephrology, P.C. | Nephrology | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570147200000",
"number": "1508840612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 WATERMAN AVE",
"city": "EAST PROVIDENCE",
"state": "RI",
"postal_code": "02914",
"telephone_number": "401-438-5950",
"fax_number": "401-435-2561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "277 PLEASANT ST",
"address_2": "STE 305",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027213005",
"telephone_number": "401-438-5950",
"fax_number": "401-435-2561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISKIND",
"first_name": "MARK",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-01",
"last_updated": "2019-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MA",
"license": "53848",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "RI",
"license": "8373",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "8373",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "10137MIR",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOSTON MEDICAL",
"identifier": "000000033673",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "39004908",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD",
"identifier": "1488",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "782413",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J30013",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6198023",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "008373",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0702100003",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED",
"identifier": "3100129",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7003280",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "004616",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3110893",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.