Individual provider Active NPI

Elise Bilodeau McCarthy, M.D.

  • Dermatology Physician
  • Quincy, MA
National Provider Identifier
1629003686
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
81161 Issued in MA
Practice address
36 Adams St
Quincy, MA 02169-2002
Phone
(617) 773-9805
Fax
(617) 474-5400
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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 81161 MA Primary

Addresses

Primary practice location

36 Adams St
Quincy, MA 02169-2002

Mailing address

36 Adams St
Quincy, MA 02169-2002
Phone (617) 773-9805

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
I20050509000999 MA Practitioner - Dermatology 6103866157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Warren Alpert Medical School of Brown University, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adams Street Dermatology Assoc, PCGroup PAC ID 0042397374, 4 clinicians

Practice addresses (Care Compare)

36 Adams St
Quincy, MA 02169-2002
Phone (617) 773-9805

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions977
Skin biopsy318

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81161MAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adams Street Dermatology Assoc, PC Dermatology CurrentSince Apr 1, 2008 Accepting new patients

Locations

36 Adams St
Quincy, MA 02169
Phone (617) 773-0711

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1629003686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 ADAMS ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692002",
            "telephone_number": "617-773-9805",
            "fax_number": "617-474-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 ADAMS ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021692002",
            "telephone_number": "617-773-9805",
            "fax_number": "617-474-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "ELISE BILODEAU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "81161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.