Individual provider Active NPI

Mariko Yasuda, M.D.

  • Dermatology Physician
  • Worcester, MA
National Provider Identifier
1073741385
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
240901 Issued in MA
Practice address
281 Lincoln St
Dermatology Residency
Worcester, MA 01605-2138
Phone
(508) 334-5971
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 240901 MA Primary

Addresses

Primary practice location

281 Lincoln St
Dermatology Residency
Worcester, MA 01605-2138

Mailing address

281 Lincoln St
Dermatology Residency
Worcester, MA 01605-2138
Phone (508) 334-5971

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
I20141018000209 MA Practitioner - Dermatology 1355562299 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Albany Medical College of Union University, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermwellesley LLCGroup PAC ID 1850644071, 9 clinicians
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

20 William St
Suite G15
Wellesley, MA 02481-4102
Phone (781) 591-4234

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions240
Removal or shaving of skin growth1-10
Skin biopsy86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240901MAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
The General Hospital Corporation CurrentSince Sep 29, 2014 Accepting new patients
Dermwellesley LLC Dermatology CurrentSince Feb 13, 2023 Accepting new patients
Massachusetts General Physicians Organization Inc Dermatology CurrentSince Sep 29, 2014 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

20 William St
Ste G15
Wellesley Hills, MA 02481
Phone (781) 591-4234

Interoperability endpoints

  • Direct secure messaging: yasuda.mariko.mgh@direct.partners.masshiway.net

Organizations & group practices 4

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 1

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1073741385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 LINCOLN ST",
            "address_2": "DERMATOLOGY RESIDENCY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052138",
            "telephone_number": "508-334-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 LINCOLN ST",
            "address_2": "DERMATOLOGY RESIDENCY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052138",
            "telephone_number": "508-334-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASUDA",
        "first_name": "MARIKO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "240901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.