DR. MARK NISSENBAUM (DMD MDC FCDSA OMFS) – Oral & Maxillofacial Surgery (D.M.D.), NPI 1902897184
Oral & Maxillofacial Surgery (D.M.D.)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
66 MAXILLOFACIAL SURGERY in MA
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Provider Addresses for DR. MARK NISSENBAUM (DMD MDC FCDSA OMFS)
Wegmans, 200, Boylston Street, Thompsonville, Newton, Middlesex County, Massachusetts, 02459, United States
SUITE 305
CHESTNUT HILL, MA 024672012
Phone: (617) 731-8888
Fax: (617) 731-3107
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)
CMS reports 1 Open Payments records for all available years, with a total value of $27.
Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.
Last reported payment date: 2023-06-08 • Largest payer in this snapshot: Nobel Biocare USA ($27).
Total Amount
$27
General + Research + Ownership
Payments
1
Total payment records
General Amount
$27
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-06-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Nobel Biocare USA | $27 |
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: 2006-08-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060801000181 | I | Maxillofacial Surgery | MA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 23 | 23 | $0 |
Insurance plans in this area (ZIP 02467)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Maxillofacial Surgery | MA | |
| D E N T I S T | MA | |
| - | MA |
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