Amy Beth Koff, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

80792 Issued in MA

Practice address

434 Route 134
Unit 1a
South Dennis, MA 02660-3433

Phone

(508) 394-5556

Fax

(508) 394-2735

NPI assigned

Sep 30, 2005

Last updated

Jul 25, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Specialty

Dermatology

Education

Baylor College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FBIFCA/Endpoint/FBIFCA

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

• Cranberry Square Dermatology PC

  • Specialist
  • South Dennis, MA
  • NPI 1982829495
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1144217670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 ROUTE 134",
            "address_2": "UNIT 1A",
            "city": "SOUTH DENNIS",
            "state": "MA",
            "postal_code": "026603433",
            "telephone_number": "508-394-5556",
            "fax_number": "508-394-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 ROUTE 134",
            "address_2": "UNIT 1A",
            "city": "SOUTH DENNIS",
            "state": "MA",
            "postal_code": "026603433",
            "telephone_number": "508-394-5556",
            "fax_number": "508-394-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFF",
        "first_name": "AMY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "80792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PROV NO",
            "identifier": "4736",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROV NO",
            "identifier": "0300324",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV NO",
            "identifier": "070011714",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PROVIDER NO",
            "identifier": "080792",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROV NO",
            "identifier": "B20338701",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NO",
            "identifier": "J16230",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUSPROVIDER NO.",
            "identifier": "MA0019324",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Lisa Johnson, LAT, ATC
• Jennifer Carole Kienstra, DPT
• David Kilgallon, LICSW
• Kindred Nursing Centers East, L.L.C. (Kindred Transitional Care and Rehabilitation-Eagle Pond)
• Bradford Russell Klaucke, D.C.
• Stephen Robert Loomis, PT
• Josephina Lopez-Brown
• Robert M Lynch, D.M.D.
• Elaine Marie Mach
• Megan L Mann, PT

• Dermatology Physician in South Dennis, MA
• Providers in South Dennis, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.