NPIMap

Organization Active NPI

New England Dermatology, P.C.

  • Dermatology Physician
  • Springfield, MA
National Provider Identifier
1356348098
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NEW ENGLAND DERMATOLOGY, P.C.
Practice address
3455 Main St
Suite 5
Springfield, MA 01107-1147
Phone
(413) 733-9600
Fax
(413) 732-6534
NPI assigned
Jul 7, 2005
Last updated
Sep 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Authorized official

Name
Michael Loosemore, MDNPI 1063619146
Title
Managing Partner
Phone
(413) 733-9600

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 Physician 207N00000X MA Primary

Addresses

Primary practice location

3455 Main St
Suite 5
Springfield, MA 01107-1147

Mailing address

3455 Main St
Suite 5
Springfield, MA 01107-1147
Phone (413) 733-9600

Other identifiers 4

IdentifierTypeStateIssuer
CC5429OtherRAILROAD MEDICARE
NEM11488OtherMABLUE CROSS BLUE SHIELD
607424OtherTUFTS HEALTH PLANS
CE3094OtherRAILROAD MEDICARE

Other names 1

  • NEW ENGLAND DERMATOLOGY & LASER CENTER Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041117000172 MA Part B Supplier - Clinic/Group Practice 9436113677 Receives reassigned benefits from 28 practitioners
Practice locations: Northampton, MA; Westfield, MA; Springfield, MA; Longmeadow, 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
22D0067526New England Dermatology, PC3455 Main St, Springfield, MA 01107ComplianceJul 19, 2027

National Provider Directory

National Provider Directory

Locations

1221 Main St
Ste 202
Holyoke, MA 01040
Phone (413) 536-0390

1221 Main St
Ste 217
Holyoke, MA 01040
Phone (413) 536-0390

175 Dwight Rd
Ste 205
Longmeadow, MA 01106
Phone (413) 565-5020

21 Dwight Rd
Ste 202
Longmeadow, MA 01106
Phone (413) 565-5020

8 Atwood Dr
Ste 304
Northampton, MA 01060
Phone (413) 586-5798

3455 Main St
Springfield, MA 01107
Phone (413) 562-6289

3455 Main St
Ste 5
Springfield, MA 01107
Phone (413) 733-9600

57 Union St
Ste 202
Westfield, MA 01085
Phone (413) 562-6189

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725408000000",
    "number": "1356348098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 MAIN ST",
            "address_2": "SUITE 5",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071147",
            "telephone_number": "413-733-9600",
            "fax_number": "413-732-6534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 MAIN ST",
            "address_2": "SUITE 5",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071147",
            "telephone_number": "413-733-9600",
            "fax_number": "413-732-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ENGLAND DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A",
        "authorized_official_last_name": "LOOSEMORE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "413-733-9600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC5429",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NEM11488",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLANS",
            "identifier": "607424",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE3094",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW ENGLAND DERMATOLOGY & LASER CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.