NPIMap

Organization Active NPI

Skincare Physicians Inc

  • Dermatology Physician
  • Chestnut Hill, MA
National Provider Identifier
1508893843
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SKINCARE PHYSICIANS INC
Practice address
1244 Boylston St
Suite 302
Chestnut Hill, MA 02467-2116
Phone
(617) 731-1600
Fax
(617) 731-1601
NPI assigned
Jun 26, 2006
Last updated
Dec 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Authorized official

Name
Bernadette Kilawee
Title
Billing Manager
Phone
(617) 848-1611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

1244 Boylston St
Suite 302
Chestnut Hill, MA 02467-2116

Mailing address

1244 Boylston St
Suite 302
Chestnut Hill, MA 02467-2116
Phone (617) 731-1600

Other identifiers 1

IdentifierTypeStateIssuer
M17880OtherMABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031205000332 MA Part B Supplier - Clinic/Group Practice 6800791450 Receives reassigned benefits from 18 practitioners
Practice locations: Chestnut Hill, MA

National Provider Directory

National Provider Directory

Locations

1244 Boylston St
Ste 302
Chestnut Hill, MA 02467
Phone (617) 731-1600

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1508893843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 BOYLSTON ST",
            "address_2": "SUITE 302",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672116",
            "telephone_number": "617-731-1600",
            "fax_number": "617-731-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 BOYLSTON ST",
            "address_2": "SUITE 302",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024672116",
            "telephone_number": "617-731-1600",
            "fax_number": "617-731-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKINCARE PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "KILAWEE",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "617-848-1611"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "M17880",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.