NPIMap

Organization Active NPI

Northeast Dermatology Associates

  • Dermatology Physician
  • Newburyport, MA
National Provider Identifier
1245510049
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NORTHEAST DERMATOLOGY ASSOCIATES
Practice address
1 Wallace Bashaw Way
Suite 1002
Newburyport, MA 01950-3875
Phone
(978) 691-5690
Fax
(978) 691-5693
NPI assigned
Aug 24, 2011
Organization subpart
Yes
Parent organization
NORTHEAST DERMATOLOGY ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Authorized official

Name
Dr. Jeremy P Finkle, M.D.NPI 1538264098
Title
President, Northeast Dermatology As
Phone
(978) 691-5690

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 MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1 Wallace Bashaw Way
Suite 1002
Newburyport, MA 01950-3875

Mailing address

401 Andover St
Suite 101
North Andover, MA 01845-5076
Phone (978) 691-5690

Other identifiers 1

IdentifierTypeStateIssuer
M15432OtherMAMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
Northeast Dermatology Associates PC3 organizations share this tax ID, including this one
Part of
Northeast Dermatology Associates PC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1245510049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ANDOVER ST",
            "address_2": "SUITE 101",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455076",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WALLACE BASHAW WAY",
            "address_2": "SUITE 1002",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503875",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST DERMATOLOGY ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST DERMATOLOGY ASSOCIATES",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "FINKLE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT, NORTHEAST DERMATOLOGY AS",
        "authorized_official_telephone_number": "978-691-5690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M15432",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.