NPIMap

Organization Active NPI

Massachusetts Dermatology Associates, P.C.

  • Dermatology Physician
  • Beverly, MA
National Provider Identifier
1396167763
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
242892 Issued in MA
Legal business name
MASSACHUSETTS DERMATOLOGY ASSOCIATES, P.C.
Practice address
900 Cummings Ctr
Suite 311-T
Beverly, MA 01915-6198
Phone
(978) 225-3376
NPI assigned
Jan 20, 2014
Last updated
Dec 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Authorized official

Name
Dr. Jordan Cummins, M.D.NPI 1538297676
Title
President
Phone
(978) 225-3376

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 242892 MA Primary

Addresses

Primary practice location

900 Cummings Ctr
Suite 311-T
Beverly, MA 01915-6198

Mailing address

900 Cummings Ctr
Suite 311-T
Beverly, MA 01915-6198

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address derm@mda.emadirect.md Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140311001042 MA Part B Supplier - Clinic/Group Practice 4284864331 Receives reassigned benefits from 17 practitioners
Practice locations: Beverly, MA

National Provider Directory

National Provider Directory
Tax ID family
Massachusetts Dermatology Associates PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

900 Cummings Ctr
Ste 311T
Beverly, MA 01915
Phone (978) 225-3376

Interoperability endpoints

  • Direct secure messaging: awerman.jessica.mda@direct.partners.masshiway.net
  • Direct secure messaging: bis.sabina.mda@direct.partners.masshiway.net
  • Direct secure messaging: bruns.margaret.mda@direct.partners.masshiway.net
  • Direct secure messaging: cummins.deborah.mda@direct.partners.masshiway.net
  • Direct secure messaging: cummins.jordan.mda@direct.partners.masshiway.net
  • Direct secure messaging: garibyan.lilit.mda@direct.partners.masshiway.net
  • Direct secure messaging: higham.catherine.mda@direct.partners.masshiway.net
  • Direct secure messaging: kemp.jacqueline.mda@direct.partners.masshiway.net
  • Direct secure messaging: klebanov.nikolai.mda@direct.partners.masshiway.net
  • Direct secure messaging: levin.adriane.mda@direct.partners.masshiway.net
  • Direct secure messaging: mclarney.richard.mda@direct.partners.masshiway.net
  • Direct secure messaging: ratushny.vladimir.mda@direct.partners.masshiway.net
  • Direct secure messaging: sullivan.marguerite.mda@direct.partners.masshiway.net
  • Direct secure messaging: wat.margaret.mda@direct.partners.masshiway.net

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1390176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1396167763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CTR",
            "address_2": "SUITE 311-T",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CTR",
            "address_2": "SUITE 311-T",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156198",
            "telephone_number": "978-225-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSACHUSETTS DERMATOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-20",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "CUMMINS",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-225-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "242892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "derm@mda.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "Secure direct mail to Massachusetts Dermatology Associates",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "900 Cummings Ctr",
            "address_2": "Suite 311-T",
            "city": "Beverly",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019156198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.