Individual provider Active NPI

Dylan Rose Waterman, M.D.

  • Dermatology Physician
  • Burlington, MA
National Provider Identifier
1548689516
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
274027 Issued in MA
Practice address
Lahey Hospital & Medical Center
67 S. Bedford Street
Burlington, MA 01805
Phone
(781) 744-5115
Fax
(781) 744-5687
NPI assigned
Apr 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 274027 MA Primary

Addresses

Primary practice location

Lahey Hospital & Medical Center
67 S. Bedford Street
Burlington, MA 01805

Mailing address

Lahey Hospital & Medical Center
67 S. Bedford Street
Burlington, MA 01805-5108
Phone (781) 744-5115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180711003942 MA Practitioner - Dermatology 3072828102 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Georgetown University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Krauss Dermatology PCGroup PAC ID 6103845094, 9 clinicians

Practice addresses (Care Compare)

1 Washington St
Suite 401
Wellesley Hills, MA 02481-1737
Phone (781) 416-3500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions260
Skin biopsy69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Krauss Dermatology PC Dermatology CurrentSince Jul 11, 2022 Accepting new patients
Lahey Clinic, Inc. CurrentSince Jul 9, 2018 Accepting new patients
Lahey Clinic, Inc CurrentSince Jul 9, 2018 Accepting new patients

Locations

75 Herrick St
Ste 219
Beverly, MA 01915
Phone (978) 927-0714

67 S Bedford St
Burlington, MA 01803
Phone (781) 744-5115

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

29 Hudson Rd
Ste 3310
Sudbury, MA 01776
Phone (978) 443-8810

1 Washington St
Ste 401
Wellesley Hls, MA 02481
Phone (781) 416-3500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1548689516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAHEY HOSPITAL & MEDICAL CENTER",
            "address_2": "67 S. BEDFORD STREET",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018055108",
            "telephone_number": "781-744-5115",
            "fax_number": "781-744-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAHEY HOSPITAL & MEDICAL CENTER",
            "address_2": "67 S. BEDFORD STREET",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "01805",
            "telephone_number": "781-744-5115",
            "fax_number": "781-744-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "DYLAN",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "274027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.