Skin & Laser Surgery Center of New England

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SKIN & LASER SURGERY CENTER OF NEW ENGLAND

Practice address

6 Courthouse LN
Suite 7
Chelmsford, MA 01824-1724

Phone

(978) 453-5559

Fax

(978) 453-4459

NPI assigned

May 12, 2006

Last updated

Sep 13, 2012By 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

Khalil A Khatri, M.D.NPI 1033169610

Title

Owner

Phone

(978) 453-5559

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 7

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.

• Khalil A Khatri, M.D.

  • Dermatology Physician
  • Chelmsford, MA
  • NPI 1033169610
  Medicare reassignment NPD Authorized official
• Leah Antoinette Collins

  • Family Nurse Practitioner
  • Danvers, MA
  • NPI 1477129559
  NPD (past)
• Mary Moccia, CNP

  • Family Nurse Practitioner
  • Lawrence, MA
  • NPI 1144778655
  NPD (past)
• Raichel Topale, NP

  • Family Nurse Practitioner
  • Worcester, MA
  • NPI 1760159941

  Single Specialty

  NPD (past)
• Anastasia Koroleva

  • Family Nurse Practitioner
  • Nashua, NH
  • NPI 1083440150
  NPD (past)
• Danielle L Mahoney, ARNP

  • Registered Nurse
  • Nashua, NH
  • NPI 1093729162
  NPD (past)
• Rachael McGinn, FNP-BC

  • Family Nurse Practitioner
  • Nashua, NH
  • NPI 1518841881
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347494400000",
    "number": "1508816042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 ALLDS ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030604745",
            "telephone_number": "603-886-5506",
            "fax_number": "603-594-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 COURTHOUSE LN",
            "address_2": "SUITE 7",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018241724",
            "telephone_number": "978-453-5559",
            "fax_number": "978-453-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN & LASER SURGERY CENTER OF NEW ENGLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2012-09-13",
        "status": "A",
        "authorized_official_last_name": "KHATRI",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-453-5559",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "9427",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "715100",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CL6494",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0082924",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M13479",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew David Simkin, M.D.
• Cedrick Simon
• Patrycja A Simoneau, LMHC
• William Peter Sinausky, RPH
• Lakshmi Sivasankar, M.D.
• Lisa Frances Slattery, SPEECH/LANGUAGE PATH
• Kayla Smith
• Rebecca K Snelgrove, LMHC
• Marlene Port Snider, PHARMACIST
• Lisa Gill Sobhian, LICSW

• Dermatology Physician in Chelmsford, MA
• Providers in Chelmsford, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; 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.