Active NPI
Francis Scott Renna, M.D.
- Procedural Dermatology Physician
- Newton Lower Falls, MA
National Provider Identifier
1780630160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Procedural Dermatology Physician
- License
- 36142
- Practice address
- 2000 Washington St
Mob Blue 120
Newton Lower Falls, MA 02462-1650 - Phone
- (617) 969-0210
- Fax
- (617) 527-6019
- NPI assigned
- May 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Procedural Dermatology Physician | 207NS0135X | 36142 | MA | Primary |
Addresses
Primary practice location
2000 Washington St
Mob Blue 120
Newton Lower Falls, MA 02462-1650
Mailing address
2000 Washington St
Mob Blue 120
Newton Lower Falls, MA 02462-1650
Phone (617) 969-0210
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3012883 | Medicaid | MA | |
| 9773479 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36142 | MA | MD | Procedural Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1780630160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 WASHINGTON ST",
"address_2": "MOB BLUE 120",
"city": "NEWTON LOWER FALLS",
"state": "MA",
"postal_code": "024621650",
"telephone_number": "617-969-0210",
"fax_number": "617-527-6019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 WASHINGTON ST",
"address_2": "MOB BLUE 120",
"city": "NEWTON LOWER FALLS",
"state": "MA",
"postal_code": "024621650",
"telephone_number": "617-969-0210",
"fax_number": "617-527-6019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNA",
"first_name": "FRANCIS",
"middle_name": "SCOTT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "MA",
"license": "36142",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3012883",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9773479",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newton Lower Falls, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.