Michael L Dern, MD
Individual provider
Active NPI
Family Medicine Physician · Abington, MA
NPI 1710968136 · NPPES record last updated Jan 12, 2024
Key facts
- NPI
- 1710968136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 43408 (MA)
- Practice address
- 360 Brockton Ave
Abington, MA 02351-2186
- Phone
- (781) 878-1700
- Fax
- (508) 894-0412
- NPI assigned
- Nov 11, 2005
- Sex
- Male
- Sole proprietor
- No
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.
Owned or controlled facilities with NPI records 2
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.83 of 100 (group)
- Quality
- 70.13
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.97
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20050324000743 |
MA |
Practitioner - Family Practice |
2163402454 |
|
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|
| 43408 | MA | MD | Family Medicine Physician |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Family Medicine Physician |
207Q00000X |
43408 |
MA |
Yes |
Addresses
Primary practice location
360 Brockton Ave
Abington, MA 02351-2186
Mailing address
360 Brockton Ave
Abington, MA 02351-2186
Phone (781) 878-1700
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 0114006 | Medicaid | MA | |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (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.