Apderm East, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

APDERM EAST, PC

Practice address

17-19 Elissa Ave
Wayland, MA 01778

Phone

(978) 371-7010

NPI assigned

Nov 22, 2021

Organization subpart

Yes

Parent organization

ADULT & PEDIATRIC DERMATOLOGY, P.C.As reported in NPPES

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

Authorized official

Name

Samuel Goos

Title

Managing Partner

Phone

(978) 371-7010

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Part of

Apderm Path

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alyssa Krieger, MSN, NP-BC

  • Nurse Practitioner
  • Wayland, MA
  • NPI 1568019032
  NPD (past)

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1740947084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 MAIN ST STE 302",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203301",
            "telephone_number": "978-371-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17-19 ELISSA AVE",
            "city": "WAYLAND",
            "state": "MA",
            "postal_code": "01778",
            "telephone_number": "978-371-7010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Boston Post Rd W Ste 200&202",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "017524667",
            "country_code": "US",
            "telephone_number": "508-460-9613",
            "fax_number": "978-371-0522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "75 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Waltham",
            "state": "MA",
            "postal_code": "024517549",
            "country_code": "US",
            "telephone_number": "978-371-7010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "APDERM EAST, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADULT & PEDIATRIC DERMATOLOGY, P.C.",
        "enumeration_date": "2021-11-22",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "GOOS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "978-371-7010"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Marion Amendola, LMT
• Kiersten Michaela Anderson, MSW, LICSW, OSW-C
• Melissa F Angel, M.T., C.D. (DONA)
• Farah Ansari, PA-C
• Kim Rynearson Antonell, LICSW
• Arnold L. Sperling, M.D.,P.C.
• At Home Personal Care
• Karen Jean Back, MD
• Carrie Bailey, MS, OTR/L
• Tania M Bandak, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.