Individual provider Active NPI

Alejandro Peralta Soler, MD

  • Dermatopathology (Pathology) Physician
  • Needham, MA
National Provider Identifier
1295775385
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
35087640 Issued in OH
Practice address
15 Crawford St Ste 100
Needham, MA 02494
Phone
(617) 969-4100
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 35087640 OH
Dermatopathology (Pathology) Physician 207ZD0900X 35087640 OH Primary

Addresses

Primary practice location

15 Crawford St Ste 100
Needham, MA 02494

Mailing address

15 Crawford St Ste 100
Needham, MA 02494-2618
Phone (617) 969-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180716001007 MA Practitioner - Pathology 9638105513 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35087640OHMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cohen Dermatopathology, P.C. Current Accepting new patients
Cohen Dermatopathology, P.C. Anatomic Pathology Current Accepting new patients

Locations

15 Crawford St
Ste 100
Needham Heights, MA 02494
Phone (617) 969-4100

1111 S Freeport Pkwy
Coppell, TX 75019
Phone (214) 277-8700

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531785600000",
    "number": "1295775385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CRAWFORD ST STE 100",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024942618",
            "telephone_number": "617-969-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CRAWFORD ST STE 100",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "02494",
            "telephone_number": "617-969-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA SOLER",
        "first_name": "ALEJANDRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "OH",
            "license": "35087640",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "OH",
            "license": "35087640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

Verify at the official NPI Registry.