Organization Active NPI

Westwood Dermatology and Dermatologic Surgery Group, PA

  • Dermatology Physician
  • Westwood, NJ
National Provider Identifier
1447331079
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MA50163 Issued in NJ
Legal business name
WESTWOOD DERMATOLOGY AND DERMATOLOGIC SURGERY GROUP, PA
Practice address
390 Old Hook Rd
Westwood, NJ 07675-2600
Phone
(201) 666-9550
Fax
(201) 666-1251
NPI assigned
Oct 18, 2006
Last updated
Jul 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Dr. Martha Jane Maso, M.D.NPI 1518968676
Title
President
Phone
(201) 666-9550

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 MA50163 NJ Primary

Addresses

Primary practice location

390 Old Hook Rd
Westwood, NJ 07675-2600

Mailing address

390 Old Hook Rd
Westwood, NJ 07675-2600
Phone (201) 666-9550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050524000256 NJ Part B Supplier - Clinic/Group Practice 1456393180 Receives reassigned benefits from 10 practitioners
Practice locations: Westwood, NJ

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
31D0113432Westwood Dermatology390 Old Hook Road, Westwood, NJ 07675ComplianceFeb 25, 2027

National Provider Directory

National Provider Directory

Locations

390 Old Hook Rd
Ste 104
Westwood, NJ 07675

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1447331079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 OLD HOOK RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076752600",
            "telephone_number": "201-666-9550",
            "fax_number": "201-666-1251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 OLD HOOK RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076752600",
            "telephone_number": "201-666-9550",
            "fax_number": "201-666-1251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTWOOD DERMATOLOGY AND DERMATOLOGIC SURGERY GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "MASO",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-666-9550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MA50163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.