Mark Clyde Gebhardt, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

47866 Issued in MA

Practice address

330 Brookline Ave
Bidmc - Stoneman 10
Boston, MA 02215-5400

Phone

(617) 667-2140

Fax

(617) 667-0227

NPI assigned

Nov 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgebhardt25782@direct.bostonchildrens.org

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.

• Beth Israel Deaconess Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1548202641
  Medicare reassignment NPD
• Children's Orthopaedic Surgery Foundation, Inc.

  • Pediatric Orthopaedic Surgery Physician
  • Boston, MA
  • NPI 1548344393
  Medicare reassignment NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  dba Orthopedic Surgery - HMFP at BIDMC

  • Orthopaedic Surgery Physician
  • Boston, MA
  • NPI 1972544591
  Medicare reassignment NPD
• Beth Israel Deaconess Medical Center, Inc.

  • Ambulance
  • Boston, MA
  • NPI 1518600501
  NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  dba Emergency Medicine - HMFP at BIDMC

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1316987993
  NPD
• Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc

  dba Dermatology - HMFP at BIDMC

  • Dermatology Physician
  • Boston, MA
  • NPI 1043250616
  NPD (past)

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689655094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BIDMC - STONEMAN 10",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-2140",
            "fax_number": "617-667-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BIDMC - STONEMAN 10",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-2140",
            "fax_number": "617-667-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBHARDT",
        "first_name": "MARK",
        "middle_name": "CLYDE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "47866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "E05505",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142379",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "047866",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Anne Geary
• Sarah Elizabeth Geary, CPNP
• John Thomas Gebert
• Rebecca Gebert
• Elizabeth Marie Gebhardt
• Daniel G. Gebremedhin, M.D.
• Mahray Gebremichael
• Harena Gebreyesus, PA-C
• Guy Gechtman
• Keara C Geckeler

• Orthopaedic Surgery Physician in Boston, MA
• Providers in Boston, MA by specialty
• Orthopaedic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.