Organization Active NPI

Metro West Dermatology

  • Dermatology Physician
  • Framingham, MA
National Provider Identifier
1144311069
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
52195 Issued in MA
Legal business name
METRO WEST DERMATOLOGY
Practice address
140 Lincoln St
Framingham, MA 01702-6306
Phone
(508) 879-8128
Fax
(508) 879-3837
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Mrs. Lynn Bleuer
Title
Office Manager
Phone
(508) 879-8128

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 52195 MA Primary

Addresses

Primary practice location

140 Lincoln St
Framingham, MA 01702-6306

Mailing address

140 Lincoln St
Framingham, MA 01702-6306
Phone (508) 879-8128

Other identifiers 5

IdentifierTypeStateIssuer
4121OtherHARVARD PILGRIM HEALTH
54737OtherFALLON SELECT & DIRECT
709234OtherMATUFTS
J03757OtherMABCBS
0004684OtherNEIGHBORHOOD HEALTH PLAN

National Provider Directory

National Provider Directory

Locations

140 Lincoln St
Framingham, MA 01702
Phone (508) 820-9330

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1144311069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026306",
            "telephone_number": "508-879-8128",
            "fax_number": "508-879-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LINCOLN ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017026306",
            "telephone_number": "508-879-8128",
            "fax_number": "508-879-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO WEST DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "BLEUER",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "508-879-8128",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MA",
            "license": "52195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "4121",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON SELECT & DIRECT",
            "identifier": "54737",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "709234",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J03757",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0004684",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Framingham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.