Adult & Pediatric Dermatology, P.C.
Organization Active NPI Dermatology Physician · Concord, MA
NPI 1285614834 · NPPES record last updated Jul 29, 2026
Key facts
- NPI
- 1285614834
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- ADULT & PEDIATRIC DERMATOLOGY, P.C.
- Practice address
- 54 Baker Avenue Ext Ste 305&306
Concord, MA 01742-2137 - Phone
- (978) 371-7010
- Fax
- (978) 371-0522
- NPI assigned
- Jan 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Samuel D Goos, MD
- Title
- Managing Partner
- Phone
- (978) 371-7010
Member organizations 2
Practitioners 57
-
Laura Archibald, M.D.
-
Barbara A Bradley, R.N.C., M.S., N.P.
-
Kathleen Burke, R.N.C.,M.S., N.P.
-
David E Geist, M.D.
-
Donald J. Grande, MD
-
Byron Ho, M.D.
-
Abby Hochberg, MD
-
Anu G Jayaraman, M.D.
-
Alyssa Krieger, MSN, NP-BC
-
Donna P Kulas, R.N.C. , M.S., N.P.
-
James SHR-Yi Liou, M.D.
-
Peter Muz, M.D.
-
Anna Pozharny, F.N.P
-
Brandon Rowe, M.D.
-
Benjamin Arthur Solky, M.D.
-
Shelley Yang, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0687234 | Adult & Pediatric Dermatology, PC | Compliance | Aug 10, 2026 |
| 22D0959317 | Adult & Pediatric Dermatology, PC | Compliance | Jun 25, 2028 |
| 22D0988935 | Adult & Pediatric Dermatology PC | Provider-performed microscopy | Jan 29, 2028 |
| 22D0998076 | Adult and Pediatric Dermatology PC | Certificate of waiver | Apr 3, 2028 |
| 22D2004899 | Adult & Pediatric Dermatology, PC | Compliance | Dec 1, 2026 |
| 22D2055988 | Adult & Pediatric Dermatology PC | Compliance | Dec 29, 2027 |
| 22D2090003 | Adult & Pediatric Dermatology PC | Compliance | Dec 20, 2026 |
| 22D2148460 | Adult & Pediatric Dermatology, PC | Provider-performed microscopy | Jun 30, 2027 |
| 22D2221623 | Adult & Pediatric Dermatology, PC | Compliance | Aug 30, 2026 |
| 30D0931906 | Adult & Pediatric Dermatology, PC | Compliance | Dec 15, 2026 |
| 30D2041961 | Adult and Pediatric Dermatology | Compliance | Jan 17, 2027 |
| 30D2146470 | Adult & Pediatric Dermatology PC | Compliance | Sep 19, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA, NH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040802000790 | MA | Part B Supplier - Clinic/Group Practice | 7012988306 |
Receives reassigned benefits from 41 practitioners Practice locations: Worcester, MA; Westford, MA; Wellesley, MA; Wayland, MA; Waltham, MA; Marlborough, MA; Stoneham, MA; Ayer, MA… |
| O20101111001171 | NH | Part B Supplier - Clinic/Group Practice | 7012988306 |
Receives reassigned benefits from 15 practitioners Practice locations: Concord, NH; Manchester, NH; Rochester, NH; Wolfeboro, NH |
National Provider Directory
Locations
190 Groton Rd
Ste 120
Ayer, MA 01432
Phone (617) 632-9848
440 E Central St
Ste 4
Franklin, MA 02038
Phone (781) 762-5858
80 Erdman Way
Leominster, MA 01453
Phone (978) 534-0230
201 Boston Post Rd W
Ste 200
Marlborough, MA 01752
Phone (508) 460-9613
340 Maple St
Ste 201
Marlborough, MA 01752
Phone (508) 460-9613
75 3rd Ave
Ste 6
Waltham, MA 02451
Phone (781) 641-4900
17 Elissa Ave
Wayland, MA 01778
133 Littleton Rd
Ste 205
Westford, MA 01886
Phone (978) 692-9978
288 Grove St
Ste 201
Worcester, MA 01605
Phone (508) 552-3130
609 S Main St
Wolfeboro, NH 03894
Phone (603) 569-4732
240 S Main St
Wolfeboro, NH 03894
Phone (603) 515-2093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes | ||
| MOHS-Micrographic Surgery Physician |
207ND0101X | |||
| Dermatopathology Physician |
207ND0900X | |||
| Anatomic Pathology & Clinical Pathology Physician |
207ZP0102X |
Addresses
Primary practice location
54 Baker Avenue Ext Ste 305&306
Concord, MA 01742-2137
Mailing address
526 Main St Ste 302
Acton, MA 01720-3310
Phone (978) 371-7010
Other practice location 1
133 Littleton Rd Ste 205&206
Westford, MA 01886-3115
Phone (978) 692-9978
Other practice location 2
87 McGregor St Ste 2100
Manchester, NH 03102-3767
Phone (603) 626-7546
Other practice location 3
55 Mill St
Wolfeboro, NH 03894-4328
Phone (603) 569-3376
Other practice location 4
1 Highlander Way
Manchester, NH 03103-7403
Phone (603) 626-7546
Other practice location 5
288 Grove St Ste 201
Worcester, MA 01605-3934
Phone (508) 552-3130
Other practice location 6
386 Washington St
Wellesley, MA 02481-6213
Phone (781) 235-1533
Other practice location 7
75 3rd Ave Ste 6
Waltham, MA 02451-7582
Phone (781) 701-8030
Other practice location 8
17-19 Elissa Ave
Suite 302
Wayland, MA 01778-3154
Phone (508) 276-6648
Other practice location 9
120 Washington St Unit 202
Rochester, NH 03839-5535
Phone (603) 255-8920
Other practice location 10
86 Baker Avenue Ext Ste 100
Concord, MA 01742-2132
Phone (978) 371-7010
Other practice location 11
190 Groton Rd Ste 120
Ayer, MA 01432-1124
Phone (978) 772-2424
Other practice location 12
80 Erdman Way Ste 100
Leominster, MA 01453-1840
Phone (978) 751-9280
Other practice location 13
201 Boston Post Rd W Ste 200&202
Marlborough, MA 01752-4667
Phone (508) 460-9613
Other practice location 14
2 Pillsbury St Ste 501
Concord, NH 03301-3576
Phone (603) 333-2908
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M17456 | Other | MA | BC/BS OF MA GROUP NUMBER |
| 607334 | Other | MA | TUFTS HEALTH PLAN GROUP # |
Other providers in Concord, MA
- Jenica Kowlowitz Abram
- Achieve New England, LLC
- Acu&Moxa Essences Inc.
- Adele Chambers D.M.D. P.C.
- Karen Adriano
- Aerodiagnostics LLC
- Afa Midwifery, Obstetrics & Gynecology
- Tsoler Aghjian
- Marie Aguirre
- Aisling Gaughan, M.D., P.C.
All providers in Concord, MA · Dermatology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.