NPIMap

Organization Active NPI

Coastal Dermatology Inc

  • Dermatology Physician
  • Westport, MA
National Provider Identifier
1760927610
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
79581 Issued in MA
Legal business name
COASTAL DERMATOLOGY INC
Practice address
829 American Legion Hwy
Westport, MA 02790-4128
Phone
(508) 306-1400
NPI assigned
Jan 2, 2017
Last updated
Oct 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Authorized official

Name
Samuel D Goos, MDNPI 1548240039
Title
Managing Partner
Phone
(978) 371-7010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 79581 MA Primary
MOHS-Micrographic Surgery Physician 207ND0101X NU
Dermatopathology Physician 207ND0900X NU
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU

Addresses

Primary practice location

829 American Legion Hwy
Westport, MA 02790-4128

Mailing address

526 Main St Ste 302
Acton, MA 01720-3310
Phone (978) 371-7010

Other practice location 1

153 E Washington St
North Attleboro, MA 02760-2312
Phone (508) 699-7546

Other practice location 2

1672 S County Trl
East Greenwich, RI 02818-5098
Phone (401) 885-7546

Other practice location 3

148 W River St
Providence, RI 02904-2615
Phone (401) 273-9310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170509002519 MA Part B Supplier - Clinic/Group Practice 3779860390 Receives reassigned benefits from 12 practitioners
Practice locations: North Attleboro, MA; North Dartmouth, MA; Westport, MA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2136858Adult & Pediatric Dermatology/Coastal Dermatology829 American Legion Highway, Westport, MA 02790ComplianceFeb 11, 2028

National Provider Directory

National Provider Directory

Locations

145 Faunce Corner Mall Rd
Ste J
North Dartmouth, MA 02747
Phone (508) 993-7601

829 American Legion Hwy
Westport, MA 02790
Phone (508) 306-1400

148 W River St
Providence, RI 02904
Phone (401) 421-6306

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1483315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791244800000",
    "number": "1760927610",
    "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": "017203310",
            "telephone_number": "978-371-7010",
            "fax_number": "978-371-0522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 AMERICAN LEGION HWY",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027904128",
            "telephone_number": "508-306-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 E Washington St",
            "address_purpose": "LOCATION",
            "city": "North Attleboro",
            "state": "MA",
            "postal_code": "027602312",
            "country_code": "US",
            "telephone_number": "508-699-7546",
            "fax_number": "508-699-7570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1672 S County Trl",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028185098",
            "country_code": "US",
            "telephone_number": "401-885-7546",
            "fax_number": "508-885-6639",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "148 W River St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029042615",
            "country_code": "US",
            "telephone_number": "401-273-9310",
            "fax_number": "401-273-1270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-02",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A",
        "authorized_official_last_name": "GOOS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "978-371-7010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "79581",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westport, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; 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.