Apderm South Shore, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

APDERM SOUTH SHORE, P.C.

Practice address

128 Carnegie Row Ste 202
Norwood, MA 02062-5162

Phone

(781) 762-5858

Fax

(781) 617-6202

NPI assigned

Apr 5, 2022

Organization subpart

Yes

Parent organization

ADULT & PEDIATRIC DERMATOLOGY, P.C.As reported in NPPES

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

Authorized official

Name

Samuel GoosNPI 1548240039

Title

Owner

Phone

(978) 371-7010

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Part of

Apderm Path

Locations

Practitioners 2

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

• Samuel D Goos, M.D.

  • Dermatology Physician
  • Concord, MA
  • NPI 1548240039
  Medicare reassignment Authorized official
• Subin M Jacob-George, PA-C

  • Physician Assistant
  • Worcester, MA
  • NPI 1831545995
  Medicare reassignment

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1013658061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 MAIN ST STE 302",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203301",
            "telephone_number": "978-371-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 CARNEGIE ROW STE 202",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625162",
            "telephone_number": "781-762-5858",
            "fax_number": "781-617-6202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Payson Rd Ste 225",
            "address_purpose": "LOCATION",
            "city": "Foxborough",
            "state": "MA",
            "postal_code": "020351309",
            "country_code": "US",
            "telephone_number": "781-762-5858",
            "fax_number": "508-543-5337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "95 Washington St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MA",
            "postal_code": "020214009",
            "country_code": "US",
            "telephone_number": "781-713-1200",
            "fax_number": "781-619-6202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "440 E Central St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "MA",
            "postal_code": "020381374",
            "country_code": "US",
            "telephone_number": "781-762-5858",
            "fax_number": "508-520-9684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "APDERM SOUTH SHORE, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADULT & PEDIATRIC DERMATOLOGY, P.C.",
        "enumeration_date": "2022-04-05",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "GOOS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-371-7010"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Norwood, MA
• Providers in Norwood, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.