NPIMap

Organization Active NPI

Northeast Dermatology Associates, PC

  • Dermatology Physician
  • Beverly, MA
National Provider Identifier
1699180620
Registry record updated Jun 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NORTHEAST DERMATOLOGY ASSOCIATES, PC
Practice address
138 Conant St
First Floor
Beverly, MA 01915-1665
Phone
(978) 691-5690
Fax
(978) 691-5693
NPI assigned
Jun 28, 2014
Last updated
Jun 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2014

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

Authorized official

Name
Dr. Jeremy P Finkle, M.D.NPI 1538264098
Title
President
Phone
(978) 691-5690

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X

Addresses

Primary practice location

138 Conant St
First Floor
Beverly, MA 01915-1665

Mailing address

401 Andover Street
Suite 101
North Andover, MA 01845-5076
Phone (978) 691-5690

Other names 1

  • NEDA Other name

National Provider Directory

National Provider Directory
Tax ID family
Northeast Dermatology Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

138 Conant St
Fl First
Beverly, MA 01915

235 Cypress St
Ste 110
Brookline, MA 02445
Phone (617) 860-6430

62 Brown St
Ste 304G
Haverhill, MA 01830

198 Massachusetts Ave
Ste 100
North Andover, MA 01845
Phone (978) 372-3893

262 S River Rd
Ste 101
Bedford, NH 03110

197 Loudon Rd
Ste 350
Concord, NH 03301

75 Gilcreast Rd
Unit 100
Londonderry, NH 03053

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1403913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403913600000",
    "number": "1699180620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ANDOVER STREET",
            "address_2": "SUITE 101",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455076",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 CONANT ST",
            "address_2": "FIRST FLOOR",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151665",
            "telephone_number": "978-691-5690",
            "fax_number": "978-691-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST DERMATOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-28",
        "last_updated": "2014-06-28",
        "status": "A",
        "authorized_official_last_name": "FINKLE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-691-5690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEDA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.