Premier Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PREMIER DERMATOLOGY, PLLC

Practice address

372 Washington St
2ND Floor
Wellesley, MA 02481-6216

Phone

(781) 205-0770

NPI assigned

Aug 18, 2019

Last updated

Aug 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Melissa Mae Burnett, MDNPI 1407837818

Title

Owner/Sole Manager

Phone

(781) 859-8157

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Melissa Mae Burnett, MD

  • Dermatology Physician
  • Boston, MA
  • NPI 1407837818
  Medicare reassignment Care Compare group NPD Authorized official
• Laura Archibald, M.D.

  • MOHS-Micrographic Surgery Physician
  • Leominster, MA
  • NPI 1790348472

  Dermatology

  Medicare reassignment Care Compare group NPD
• Jacqueline Moreau Kemp, MD, MS

  • Dermatology Physician
  • Wellesley, MA
  • NPI 1598183709
  Medicare reassignment Care Compare group NPD
• Elissa J Lunder, MD

  • Dermatology Physician
  • Wellesley, MA
  • NPI 1457300964
  Medicare reassignment Care Compare group NPD
• Virginia Ann Moye, MD, MPH

  • Dermatology Physician
  • Wellesley, MA
  • NPI 1871908228
  Medicare reassignment Care Compare group NPD
• Kristen Rivard, ANP-BC, WHCNP-BC

  • Nurse Practitioner
  • Wellesley, MA
  • NPI 1881134203
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566086400000",
    "number": "1669028353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 NORTH AVE",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931839",
            "telephone_number": "781-859-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "372 WASHINGTON ST",
            "address_2": "2ND FLOOR",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816216",
            "telephone_number": "781-205-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-18",
        "last_updated": "2019-08-18",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "OWNER/SOLE MANAGER",
        "authorized_official_telephone_number": "781-859-8157",
        "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": []
}

• Timothy Post, ATC
• Christina Potenza
• Power Play Physical Therapy & Performance LLC
• Pratt Medical Group, Inc (Wellesley Center for Sleep Medicine, Tufts Medical Center)
• Premier Dental Group of Wellesley, P.C.
• Premier Medical Associates
• Premier Vision Consultants, LLC
• Anhthy Trinh Prendeville, O.D.
• Primary Care Pediatrics
• Alex T Prior, LICSW

• Dermatology Physician in Wellesley, MA
• Providers in Wellesley, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.