NPIMap

Organization Active NPI

Boston University Dermatology, Inc.

  • Dermatology Physician
  • Boston, MA
National Provider Identifier
1376532853
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BOSTON UNIVERSITY DERMATOLOGY, INC.
Practice address
725 Albany St, Suite 8B
Shapiro BLDG
Boston, MA 02118
Phone
(617) 638-7420
Fax
(617) 638-7289
NPI assigned
Oct 18, 2005
Last updated
Dec 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Rhoda M. AlaniNPI 1154385268
Title
President
Phone
(617) 638-7249

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
Dermatopathology Physician 207ND0900X NU
Pediatric Dermatology Physician 207NP0225X NU

Addresses

Primary practice location

725 Albany St, Suite 8B
Shapiro BLDG
Boston, MA 02118

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118-2690

Other identifiers 2

IdentifierTypeStateIssuer
110072443AMedicaidMA
3115042MedicaidNH

Other names 1

  • Faculty Practice Foundation Inc Boston University Dermatology Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040226000806 MA Part B Supplier - Clinic/Group Practice 7012803919 Receives reassigned benefits from 19 practitioners
Practice locations: Boston, 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
22D0698445Boston University Dermatology, Inc725 Albany Street, Suite 8B, Boston, MA 02118ComplianceApr 11, 2027

National Provider Directory

National Provider Directory

Locations

609 Albany St
Fl 3
Boston, MA 02118
Phone (617) 638-5566

720 Harrison Ave
Ste 915
Boston, MA 02118
Phone (617) 638-7420

725 Albany St
#8
Boston, MA 02118
Phone (617) 414-4841

725 Albany St
Bldg 8TH
Boston, MA 02118

725 Albany St
Ste 8B
Boston, MA 02118
Phone (617) 638-7420

850 Harrison Ave
#2
Boston, MA 02118
Phone (617) 414-4020

Practitioners & affiliated clinicians

Practitioners 100

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 100

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1376532853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST, SUITE 8B",
            "address_2": "SHAPIRO BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-7420",
            "fax_number": "617-638-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON UNIVERSITY DERMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "ALANI",
        "authorized_official_first_name": "RHODA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-638-7249"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110072443A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3115042",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Faculty Practice Foundation Inc Boston University Dermatology Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Faculty Practice Foundation Inc Boston University Dermatology Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.