Dr Stephen Takeo Nishiyama, MD - Medicare Pediatrics in Waltham, MA

Dr Stephen Takeo Nishiyama, MD is a medicare enrolled "Pediatrics" physician in Waltham, Massachusetts. His current practice location is 40 Second Ave, Ste 400, Waltham, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (781) 487-4340.

Dr Stephen Takeo Nishiyama is licensed to practice in Massachusetts (license number 81412) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710978622.

Contact Information

Dr Stephen Takeo Nishiyama, MD
40 Second Ave, Ste 400,
Waltham, MA 02451
(781) 487-4340
(781) 487-4341



Physician's Profile

Full NameDr Stephen Takeo Nishiyama
GenderMale
SpecialityPediatrics
Location40 Second Ave, Waltham, Massachusetts
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1710978622
  • Provider Enumeration Date: 10/31/2005
  • Last Update Date: 01/03/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 9436225091
  • Enrollment ID: I20080904000521

Medical Identifiers

Medical identifiers for Dr Stephen Takeo Nishiyama such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710978622NPI-NPPES
081412OtherMATUFTS HEALTH PLAN
J31669OtherMABCBS MA
3141683MedicaidMA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 81412 (Massachusetts)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Stephen Takeo Nishiyama allows following entities to bill medicare on his behalf.
Entity NameMassachusetts General Physicians Organization Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801874573
PECOS PAC ID: 2466365820
Enrollment ID: O20031111000434

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Entity NameThe General Hospital Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023049236
PECOS PAC ID: 6507803806
Enrollment ID: O20080313000351

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Stephen Takeo Nishiyama is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Stephen Takeo Nishiyama, MD
Po Box 9142, Mass General Physician Organization,
Charlestown, MA 02129-9142

Ph: (781) 487-4340
Dr Stephen Takeo Nishiyama, MD
40 Second Ave, Ste 400,
Waltham, MA 02451

Ph: (781) 487-4340

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› Verified 6 days ago


Pediatrics Doctors in Waltham, MA

Dr. Robert D Fusunyan, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 40 2nd Avenue, Suite 340, Waltham, MA 02451
Phone: 781-466-8967    Fax: 781-466-8987
Dr. Beth Ann Mccabe, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 40 2nd Ave, Suite 400, Waltham, MA 02451
Phone: 781-522-9000    Fax: 617-735-9098
Cynthia Sacco, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 245 Winter St, Waltham, MA 02451
Phone: 781-419-2709    
Myron B Peterson, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: Cato Ltd., 1100 Winter Street, Waltham, MA 02451
Phone: 617-484-2297    
Dr. Peter Tebet Greenspan, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 40 2nd Ave, Mass General West Medical Group Ste 400, Waltham, MA 02451
Phone: 781-487-4340    Fax: 781-487-4341
Dr. Sarah Pritchett Zimmerman, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 40 2nd Ave Ste 400, Waltham, MA 02451
Phone: 781-487-4340    
James I Goldston, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 42 Weston St Ste 2a, Waltham, MA 02453
Phone: 781-747-8480    Fax: 949-577-4121

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