Cape Cod Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

74240 Issued in MA

Legal business name

CAPE COD DERMATOLOGY, LLC

Practice address

134 Ansel Hallet Rd
W Yarmouth, MA 02673-2582

Phone

(508) 771-9779

Fax

(508) 771-4355

NPI assigned

May 22, 2013

Last updated

May 22, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Wyman Fiske, M.D.

Title

Owner/Physician

Phone

(508) 771-9779

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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.

• William Wyman Fiske, M.D.

  • Dermatology Physician
  • W Yarmouth, MA
  • NPI 1780624213
  Medicare reassignment Care Compare group NPD
• Elizabeth M Tocci, MD

  • Dermatology Physician
  • West Yarmouth, MA
  • NPI 1073995163
  Medicare reassignment Care Compare group NPD
• Marie Bernay Schreiner, PA-C

  • Physician Assistant
  • W Yarmouth, MA
  • NPI 1255744496
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369180800000",
    "number": "1437595006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ANSEL HALLET RD",
            "city": "W YARMOUTH",
            "state": "MA",
            "postal_code": "026732582",
            "telephone_number": "508-771-9779",
            "fax_number": "508-771-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 ANSEL HALLET RD",
            "city": "W YARMOUTH",
            "state": "MA",
            "postal_code": "026732582",
            "telephone_number": "508-771-9779",
            "fax_number": "508-771-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE COD DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-05-22",
        "status": "A",
        "authorized_official_last_name": "FISKE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "WYMAN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "508-771-9779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "74240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11095135A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00429633",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J11263",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean M Connors, PT
• Nancy T Couture, MA
• Kathleen Doyle, PTA
• Paula M Fabyan, LICSW
• Darlene Marie Faherty, CCC

• Dermatology Physician in W Yarmouth, MA
• Providers in W Yarmouth, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.