Michael L Dern, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

43408 Issued in MA

Practice address

360 Brockton Ave
Abington, MA 02351-2186

Phone

(781) 878-1700

Fax

(508) 894-0412

NPI assigned

Nov 11, 2005

Last updated

Jan 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as group

Quality

70.13

Promoting interoperability

100

Improvement activities

40

Cost

75.97

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Brockton Hospital, Inc.

  dba Signature Healthcare Brockton Hospital

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286

  Corporate Director

  CMS ownership
• Brockton Hospital, Inc.

  dba Signature Healthcare Brockton Hospital

  • Psychiatric Hospital Unit
  • Brockton, MA
  • NPI 1689695405

  Corporate Director

  CMS ownership

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

• Bridgewater Goddard Park Medical Associates, Inc.

  dba Signature Medical Group

  • Multi-Specialty Clinic/Center
  • Brockton, MA
  • NPI 1417932591
  NPD (past)

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1710968136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 BROCKTON AVE",
            "city": "ABINGTON",
            "state": "MA",
            "postal_code": "023512186",
            "telephone_number": "781-878-1700",
            "fax_number": "508-894-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BROCKTON AVE",
            "city": "ABINGTON",
            "state": "MA",
            "postal_code": "023512186",
            "telephone_number": "781-878-1700",
            "fax_number": "508-894-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERN",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "43408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniella Moreira
• Quynh-Oanh V. Dao
• Sridhar H Dasari, MD
• Jaime E Dean, COTA/L
• Laura Zuleme Delaplain, PHD
• Destiny Love Dias, LMT
• Alexander Michael Dilucia
• John D Diorio, MD
• Lois Anne Dipasqua, LMHC 4805
• Chelsea Dodge, PHARMD

• Family Medicine Physician in Abington, MA
• Providers in Abington, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.