NPIMap

Organization Active NPI

Contemporary Dermatology LLC

  • Dermatology Physician
  • Marstons Mills, MA
National Provider Identifier
1528640786
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CONTEMPORARY DERMATOLOGY LLC
Practice address
3880 Falmouth Rd
Marstons Mills, MA 02648-1855
Phone
(201) 704-5557
NPI assigned
Apr 26, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Authorized official

Name
Dr. Robert Nossa, MDNPI 1023089554
Title
Owner
Phone
(201) 704-5557

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3880 Falmouth Rd
Marstons Mills, MA 02648-1855

Mailing address

159 Upper Mountain Ave
Montclair, NJ 07042-1905
Phone (201) 704-5557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211020000219 MA Part B Supplier - Clinic/Group Practice 8628475647 Receives reassigned benefits from 10 practitioners
Practice locations: Hyannis, MA; Marstons Mills, MA
O20251230002840 NJ Part B Supplier - Clinic/Group Practice 8628475647 Receives reassigned benefits from 3 practitioners
Practice locations: Basking Ridge, NJ

National Provider Directory

National Provider Directory

Locations

1070 Iyannough Rd
Unit 50
Hyannis, MA 02601

3880 Falmouth Rd
Marstons Mls, MA 02648
Phone (508) 492-3200

25 Mountainview Blvd
Ste 206B
Basking Ridge, NJ 07920
Phone (908) 549-5800

25 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 758-1006

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1528640786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 UPPER MOUNTAIN AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070421905",
            "telephone_number": "201-704-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 FALMOUTH RD",
            "city": "MARSTONS MILLS",
            "state": "MA",
            "postal_code": "026481855",
            "telephone_number": "201-704-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTEMPORARY DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "NOSSA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-704-5557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marstons Mills, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.