NPIMap

Organization Active NPI

Nedas LLC

Doing business as Northeast Dermatology Associates

  • Dermatology Physician
  • North Andover, MA
National Provider Identifier
1043683923
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NEDAS LLC
Doing business as
Northeast Dermatology Associates
Practice address
401 Andover St
Suite 101
North Andover, MA 01845-5076
Phone
(978) 691-5690
NPI assigned
Nov 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Authorized official

Name
Dr. Jeremy P Finkle, M.D.NPI 1538264098
Title
President
Phone
(978) 691-5696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

401 Andover St
Suite 101
North Andover, MA 01845-5076

Mailing address

401 Andover St
Suite 101
North Andover, MA 01845-5076
Phone (978) 691-5690

Other names 1

  • NORTHEAST DERMATOLOGY ASSOCIATES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000655 MA Part B Supplier - Clinic/Group Practice 3072403799 Receives reassigned benefits from 70 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Falmouth, MA; West Roxbury, MA; Swansea, MA; Salem, MA; Plymouth, MA; Norwell, MA; North Andover, MA; Newburyport, MA…

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

62 Brown St
Ste 304C
Haverhill, MA 01830
Phone (603) 552-3309

1 Widger Rd
Ste 301
Marblehead, MA 01945
Phone (781) 797-7070

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1043683923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ANDOVER ST",
            "address_2": "SUITE 101",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455076",
            "telephone_number": "978-691-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 ANDOVER ST",
            "address_2": "SUITE 101",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455076",
            "telephone_number": "978-691-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEDAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "FINKLE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-691-5696",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHEAST DERMATOLOGY ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.