MARK WADE DICKINSON (MD) – Pediatrics Physician, NPI 1154320059

MARK WADE DICKINSON (MD) is a healthcare provider. based in Boston, Massachusetts. specializing in INTERNAL MEDICINE, PEDIATRIC MEDICINE. They hold the professional credentials MD. They hold a License No. 230380 (MA). The NPI Number for MARK WADE DICKINSON (MD) is 1154320059

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
MARK WADE DICKINSON (MD)
NPI
1154320059
Phone
(617) 267-7171
Address
388 COMMONWEALTH AVE
Enumeration Date
21 July 2005
Last Update Date
12 August 2009

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN DIEGO SCHOOL OF MEDICINE
Secondary Phone
8572828100
Graduation Year
1989 (37 years ago)
PAC ID
3678542271
Group Practice PAC ID
3971987108
Professional Enrollment ID
I20070406000229
Address ID
MA018034945BU47XXXTPKE300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

7,722 INTERNAL MEDICINE in MA

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Provider Addresses for MARK WADE DICKINSON (MD)

  • MGH Back Bay HealthCare Center, 388, Commonwealth Avenue, Back Bay, Boston, Suffolk County, Massachusetts, 02115, United States

    MGH BACK BAY

    BOSTON, MA 022152800

    Phone: (617) 267-7171

    Fax: (617) 262-2608

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-04-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070406000229IInternal MedicineMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes21195$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes9548$0
99215Established patient office or other outpatient visit, 40-54 minutes5238$0
99443Telephone medical discussion with physician, 21-30 minutes5135$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes4628$0
View full utilization report →

Insurance plans in this area (ZIP 02215)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971987108View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)SC
A N E S T H E S I O L O G YMA
Internal MedicineOH
Certified Registered Nurse Anesthetist (Crna)MA
A N E S T H E S I O L O G YMA
A N E S T H E S I O L O G YMN
Internal Medicine, HospitalistMA
A N E S T H E S I O L O G YMA
A N E S T H E S I O L O G YNH
Cardiovascular Disease (Cardiology), Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)MA

Reviews

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Frequently asked questions

What federal number belongs to MARK WADE DICKINSON (MD)?
The federal identifier for MARK WADE DICKINSON (MD) is NPI 1154320059.
Is MARK WADE DICKINSON (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does MARK WADE DICKINSON (MD) treat or focus on?
Patients typically see MARK WADE DICKINSON (MD) under the specialty Pediatrics Physician. Clinical services aligned with this taxonomy classification.
What location shows for MARK WADE DICKINSON (MD)?
We surface Boston, Massachusetts for MARK WADE DICKINSON (MD) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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