Organization Active NPI

Lexington-Waltham Dermatology Group Inc

  • Specialist
  • Lexington, MA
National Provider Identifier
1255463972
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LEXINGTON-WALTHAM DERMATOLOGY GROUP INC
Practice address
57 Bedford St Ste 201
Lexington, MA 02420-4550
Phone
(781) 862-2322
Fax
(781) 863-0927
NPI assigned
Mar 9, 2007
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Samuel D 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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary
Dermatology Physician 207N00000X
MOHS-Micrographic Surgery Physician 207ND0101X
Dermatopathology Physician 207ND0900X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X

Addresses

Primary practice location

57 Bedford St Ste 201
Lexington, MA 02420-4550

Mailing address

526 Main St Ste 302
Acton, MA 01720-3310
Phone (978) 371-7010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081126000385 MA Part B Supplier - Clinic/Group Practice 1850451469 Receives reassigned benefits from 5 practitioners
Practice locations: Lexington, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D1019451Lexington-Waltham Dermatology Group PC57 Bedford Street, Suite 201, Lexington, MA 02420Provider-performed microscopyNov 18, 2027

National Provider Directory

National Provider Directory

Locations

57 Bedford St
Ste 201
Lexington, MA 02420
Phone (781) 862-2322

57 Bedford St
Ste 211
Lexington, MA 02420
Phone (781) 862-2322

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1255463972",
    "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": "017203310",
            "telephone_number": "978-371-7010",
            "fax_number": "978-371-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 BEDFORD ST STE 201",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024204550",
            "telephone_number": "781-862-2322",
            "fax_number": "781-863-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEXINGTON-WALTHAM DERMATOLOGY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A",
        "authorized_official_last_name": "GOOS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "978-371-7010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.