Vibrant Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

254815 Issued in MA

Legal business name

VIBRANT DERMATOLOGY PLLC

Practice address

588 Providence Hwy
Dedham, MA 02026-6804

Phone

(781) 708-9299

Fax

(855) 699-6813

NPI assigned

Apr 12, 2018

Last updated

Feb 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joyce Imahiyerobo, MDNPI 1104086107

Title

Owner/Provider

Phone

(617) 840-9034

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18428/brand/1/csg/1/fhir/r4
• FHIR API: https://app.meldrx.com/api/fhir/ez_00312

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joyce Imahiyerobo

  • Dermatology Physician
  • Norwell, MA
  • NPI 1104086107
  Medicare reassignment NPD Authorized official
• Vicky Kim Nguyen

  • Physician Assistant
  • Dedham, MA
  • NPI 1073350807
  NPD
• Katherine Geyer Strader, PA-C

  • Physician Assistant
  • Dedham, MA
  • NPI 1881471183
  NPD

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582934400000",
    "number": "1023515277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 DEDHAM ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211566",
            "telephone_number": "617-840-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 PROVIDENCE HWY",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020266804",
            "telephone_number": "781-708-9299",
            "fax_number": "855-699-6813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "226 Dedham St",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MA",
            "postal_code": "020211566",
            "country_code": "US",
            "telephone_number": "617-840-9034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIBRANT DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-12",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A",
        "authorized_official_last_name": "IMAHIYEROBO",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "617-840-9034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "254815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110098002A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denis Augustine Vaughan, MB BCH BAO MRCPI
• Vein and Aesthetic Center of Boston
• Melanie Venuti
• Andrea L Vianna, MD
• Vibrant ABA Ma, LLC
• Amandha Vielman
• April Danielle Violante, RD, LDN
• Visions Medical Center, PC
• Visology Inc (VISOLOGY @Dedham)
• Vitality Well Mental Health Providers Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2020; 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.