Organization Active NPI

Westford Dermatology and Cosmetic Center LLC

  • Dermatology Physician
  • Westford, MA
National Provider Identifier
1003161381
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
WESTFORD DERMATOLOGY AND COSMETIC CENTER LLC
Practice address
506 Groton Rd
Westford, MA 01886-6326
Phone
(978) 399-0061
Fax
(978) 399-0069
NPI assigned
Jul 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Authorized official

Name
John F Olivieri
Title
Cfo
Phone
(978) 399-0061

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X

Addresses

Primary practice location

506 Groton Rd
Westford, MA 01886-6326

Mailing address

506 Groton Rd
Westford, MA 01886-6326
Phone (978) 399-0061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121102000003 MA Part B Supplier - Clinic/Group Practice 6305096181 Receives reassigned benefits from 6 practitioners
Practice locations: Westford, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1003161381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 GROTON RD",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018866326",
            "telephone_number": "978-399-0061",
            "fax_number": "978-399-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 GROTON RD",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018866326",
            "telephone_number": "978-399-0061",
            "fax_number": "978-399-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTFORD DERMATOLOGY AND COSMETIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-23",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "OLIVIERI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "978-399-0061"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.