Dermatology Associates of Concord Inc
Organization Active NPI Dermatology Physician · Concord, MA
NPI 1508964230 · NPPES record last updated Sep 27, 2017
Key facts
- NPI
- 1508964230
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- DERMATOLOGY ASSOCIATES OF CONCORD INC
- Practice address
- 290 Baker Ave
Concord, MA 01742-2189 - Phone
- (978) 369-9023
- Fax
- (978) 371-9675
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Terry P Hadley, M.D.
- Title
- President
- Phone
- (978) 369-9023
Practitioners 21
-
Christina Nasrin Alavian, M.D.
-
Kathryn E Bowers, MD
-
Adam Brys, MD
-
Eileen M Deignan, MD
-
Julie Arline Fenner, M.D
-
Cheryl Gray, MD
-
Alexis C Perkins, MD
-
Adriano Piris, M.D.
-
Susan M Sweeney, M.D.
-
Sally Tan Renehan, MD, MPH
-
Matthew T Zipoli, MD
-
Lauren Alberta-Wszolek, M.D.
-
Laura Ann Helsing, PA-C, MPAS, MPH
-
Sarah Elizabeth Michaud, MHS, PA-C
-
Lea Murphy, PA-C
-
Caroline L Levine, M.D.
-
Terry P Hadley, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D0070557 | Dermatology Associates of Concord Inc | Compliance | Nov 9, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050914001078 | MA | Part B Supplier - Clinic/Group Practice | 6901839539 |
Receives reassigned benefits from 20 practitioners Practice locations: Cambridge, MA; Concord, MA; Waltham, MA |
National Provider Directory
Locations
625 Mount Auburn St
Ste 101B
Cambridge, MA 02138
Phone (617) 354-6568
290 Baker Ave
Ste N217
Concord, MA 01742
290 Baker Ave
Ste N220
Concord, MA 01742
Phone (978) 254-1600
290 Baker Ave
Ste 114
Concord, MA 01742
290 Baker Ave
Ste N114
Concord, MA 01742
290 Baker Ave
Ste 220
Concord, MA 01742
355 Waverly Oaks Rd
Waltham, MA 02452
Phone 7813147600 ext. 319
355 Waverly Oaks Rd
Ste 200
Waltham, MA 02452
Phone (781) 647-6920
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes |
Addresses
Primary practice location
290 Baker Ave
Concord, MA 01742-2189
Mailing address
290 Baker Ave
Concord, MA 01742-2189
Phone (978) 369-9023
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M11607 | Other | MA | BLUE S HIELD |
| 9703713 | Medicaid | MA |
Other providers in Concord, MA
- Melissa Delrossi
- Pamela Deluca
- Dennis P. Berk, M.D., P.C.
- Desmen Depaulis
- Emily J Deringer
- Jennifer I Desaulniers
- Andrea Desharone
- Jeff C Desjarlais
- Daniel Devoe
- Jordan Lynne Dewhurst
All providers in Concord, MA · Dermatology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.