Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Stephen Takeo Nishiyama, MD

Individual provider Pediatrics Physician · NPI 1710978622

Dr. Stephen Takeo Nishiyama, MD is a Pediatric Medicine in Waltham, Massachusetts. Graduated from University of Vermont College of Medicine in 1991, 35 years ago. Practices with Massachusetts General Physicians Organization Inc, a 3,484-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
35
Trained at
University of Vermont College of Medicine
Licensed in
MA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

40 Second Ave Ste 400
Waltham, MA 02451
Phone: (781) 487-4340
Fax: (781) 487-4341
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 81412 (MA)

Record details

NPI number1710978622
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 31, 2005
Last updated in NPPESJanuary 3, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolUNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Graduated 1991 (35 years in practice)
Group practice Massachusetts General Physicians Organization Inc — 3484 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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