Organization Active NPI

Vue Dermatology & Laser, LLC

  • Dermatology Physician
  • Norwood, MA
National Provider Identifier
1235940412
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
VUE DERMATOLOGY & LASER, LLC
Practice address
115 Norwood Park S Ste 202
Norwood, MA 02062-4633
Phone
(781) 725-0505
Fax
(781) 725-0555
NPI assigned
Jan 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Philip Eliades, MDNPI 1861840290
Title
Owner
Phone
(401) 368-3731

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

115 Norwood Park S Ste 202
Norwood, MA 02062-4633

Mailing address

115 Norwood Park S Ste 202
Norwood, MA 02062-4633
Phone (781) 725-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250123002998 MA Part B Supplier - Clinic/Group Practice 9234668062 Receives reassigned benefits from 2 practitioners
Practice locations: Norwood, MA

National Provider Directory

National Provider Directory

Locations

115 Norwood Park S
Ste 202
Norwood, MA 02062
Phone (781) 725-0505

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1235940412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 NORWOOD PARK S STE 202",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624633",
            "telephone_number": "781-725-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 NORWOOD PARK S STE 202",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020624633",
            "telephone_number": "781-725-0505",
            "fax_number": "781-725-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VUE DERMATOLOGY & LASER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "ELIADES",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-368-3731",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.