Individual provider Active NPI

Jessica Suzanne Mosher, MD

  • MOHS-Micrographic Surgery Physician
  • Wellesley Hills, MA
National Provider Identifier
1063471050
Registry record updated Oct 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
217725 Issued in MA
Practice address
62 Walnut St Ste 1
Wellesley Hills, MA 02481-2109
Phone
(781) 400-0469
Fax
(617) 604-2168
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 217725 MA
Clinical & Laboratory Dermatological Immunology Physician 207NI0002X 217725 MA
MOHS-Micrographic Surgery Physician 207ND0101X 217725 MA Primary
Procedural Dermatology Physician 207NS0135X 217725 MA
Dermatopathology Physician 207ND0900X 217725 MA

Addresses

Primary practice location

62 Walnut St Ste 1
Wellesley Hills, MA 02481-2109

Mailing address

68 Wellesley Rd
Belmont, MA 02478-2125
Phone (617) 710-6585

Other identifiers 1

IdentifierTypeStateIssuer
2139677MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329000424 MA Practitioner - Dermatology 0345132874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Stanford University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Ear Nose and Throat LLCGroup PAC ID 7618125931, 11 clinicians
Maritime Mohs PCGroup PAC ID 6507359510, 3 clinicians

Practice addresses (Care Compare)

2000 Washington St
Mob White 544
Newton, MA 02462-1646
Phone (617) 910-0368

62 Walnut St
Wellesley Hills, MA 02481-2113
Phone (781) 400-0469

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision150
Removal of tissue11
Removal of skin lesions309
Removal of skin cancer516
Skin biopsy193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
217725MAMDClinical & Laboratory Dermatological Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maritime Mohs PC Dermatology CurrentSince Apr 18, 2017 Accepting new patients
New England Ear Nose and Throat LLC Dermatology CurrentSince Jun 1, 2024 Accepting new patients
President & Fellows of Harvard College Past Accepting new patients

Locations

2000 Washington St
Ste 544
Newton Lower Falls, MA 02462
Phone (617) 910-0368

62 Walnut St
Wellesley Hills, MA 02481
Phone (781) 235-5275

62 Walnut St
Ste 1
Wellesley Hills, MA 02481
Phone (617) 710-6585

Interoperability endpoints

  • Direct secure messaging: mosher.jessica.mkdmd@direct.partners.masshiway.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1063471050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 WELLESLEY RD",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024782125",
            "telephone_number": "617-710-6585",
            "fax_number": "617-710-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 WALNUT ST STE 1",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024812109",
            "telephone_number": "781-400-0469",
            "fax_number": "617-604-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSHER",
        "first_name": "JESSICA",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "217725",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "MA",
            "license": "217725",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MA",
            "license": "217725",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MA",
            "license": "217725",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MA",
            "license": "217725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2139677",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

Verify at the official NPI Registry.