NPIMap

Organization Active NPI

Apderm Mid Shore PC

  • Dermatology Physician
  • Stoneham, MA
National Provider Identifier
1144993940
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
APDERM MID SHORE PC
Practice address
92 Montvale Ave
Stoneham, MA 02180-3647
Phone
(781) 358-8429
NPI assigned
Jul 28, 2021
Last updated
Jul 28, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MYSTIC VALLEY DERMATOLOGY ASSOCIATES, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Samuel Goos, MDNPI 1548240039
Title
Managing Partner
Phone
(978) 371-7010

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 Physician 207N00000X Primary

Addresses

Primary practice location

92 Montvale Ave
Stoneham, MA 02180-3647

Mailing address

526 Main St Ste 302
Acton, MA 01720-3301
Phone (978) 371-7010

National Provider Directory

National Provider Directory
Part of
Mystic Valley Dermatology

Locations

11 Shore Rd
Ste 203
Winchester, MA 01890
Phone (781) 438-6350

Practitioners & affiliated clinicians

Practitioners 6

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": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1144993940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 MAIN ST STE 302",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203301",
            "telephone_number": "978-371-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 MONTVALE AVE",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021803647",
            "telephone_number": "781-358-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APDERM MID SHORE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYSTIC VALLEY DERMATOLOGY ASSOCIATES, P.C.",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "GOOS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "978-371-7010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.