NPIMap

Organization Active NPI

Northeast Dermatology Associates, PC

  • Specialist
  • Exeter, NH
National Provider Identifier
1508061839
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NORTHEAST DERMATOLOGY ASSOCIATES, PC
Practice address
23 Hampton Rd
Exeter, NH 03833-4807
Phone
(978) 470-1973
Fax
(978) 470-1722
NPI assigned
Jun 18, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Dr. Jeremy P Finkle, M.D.NPI 1538264098
Title
President
Phone
(978) 691-5690

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

23 Hampton Rd
Exeter, NH 03833-4807

Mailing address

280 Merrimack St Ste 311
Lawrence, MA 01843-1779
Phone (978) 691-5690

Other practice location 1

721 Chestnut St
Manchester, NH 03104-3002
Phone (978) 691-5690

Other practice location 2

155 Borthwick Ave
Portsmouth, NH 03801-7156
Phone (978) 691-5690

Other practice location 3

75 Gilcreast Rd Unit 100
Londonderry, NH 03053-3567
Phone (978) 691-5690

Other practice location 4

262 S River Rd
Bedford, NH 03110-6916
Phone (978) 691-5690

Other practice location 5

111 Loudon Rd
Concord, NH 03301-5605
Phone (978) 691-5690

Other practice location 6

51 Webb Pl
Dover, NH 03820-2454
Phone (978) 691-5690

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060105000473 NH Part B Supplier - Clinic/Group Practice 3072403799 Receives reassigned benefits from 32 practitioners
Practice locations: Dover, NH; Salem, NH; Portsmouth, NH; North Conway, NH; Manchester, NH; Londonderry, NH; Exeter, NH; Concord, NH…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
30D2258619Northeast Dermatology Associates75 Gilcreast Rd, Londonderry, NH 03053Certificate of waiverApr 24, 2028

National Provider Directory

National Provider Directory

Locations

138 Conant St
Ste 1
Beverly, MA 01915

262 S River Rd
Bedford, NH 03110
Phone (603) 334-1120

51 Webb Pl
Ste 240
Dover, NH 03820

111 Maplewood Ave
Ste A
Portsmouth, NH 03801

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1508061839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MERRIMACK ST STE 311",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431779",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 HAMPTON RD",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038334807",
            "telephone_number": "978-470-1973",
            "fax_number": "978-470-1722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031043002",
            "country_code": "US",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 Borthwick Ave",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038017156",
            "country_code": "US",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 Gilcreast Rd Unit 100",
            "address_purpose": "LOCATION",
            "city": "Londonderry",
            "state": "NH",
            "postal_code": "030533567",
            "country_code": "US",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "262 S River Rd",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106916",
            "country_code": "US",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Loudon Rd",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033015605",
            "country_code": "US",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 Webb Pl",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "NH",
            "postal_code": "038202454",
            "country_code": "US",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHEAST DERMATOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "FINKLE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-691-5690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.