Attleboro Dermatology, P.C.
Organization Active NPI Dermatology Physician · Attleboro, MA
NPI 1811965296 · NPPES record last updated Dec 1, 2009
Key facts
- NPI
- 1811965296
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 76041 (MA)
- Legal business name
- ATTLEBORO DERMATOLOGY, P.C.
- Practice address
- 152 Emory St
Attleboro, MA 02703-2434 - Phone
- (508) 226-0400
- Fax
- (508) 226-3301
- NPI assigned
- Mar 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Andrew David Samel, MD
- Title
- Physician
- Phone
- (508) 226-0400
Practitioners 3
-
Andrew David Samel, M.D.
-
Foram Patel, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D1013646 | Attleboro Dermatology PC | Provider-performed microscopy | Jun 12, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050614000199 | MA | Part B Supplier - Clinic/Group Practice | 1658315411 |
Receives reassigned benefits from 3 practitioners Practice locations: Attleboro, MA |
National Provider Directory
Locations
152 Emory St
Unit 2
Attleboro, MA 02703
Phone (508) 226-0400
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JEIFBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | 76041 | MA | Yes |
Addresses
Primary practice location
152 Emory St
Attleboro, MA 02703-2434
Mailing address
152 Emory St
Attleboro, MA 02703-2434
Phone (508) 226-0400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005389 | Other | RI | BLUE CHIP |
| CK7613 | Other | MA | RAILROAD MEDICARE |
| 227085 | Other | RI | RHODE ISLAND B/SHIELD |
| 695110 | Other | MA | TUFTS |
| 9722301 | Medicaid | MA | |
| 401164 | Other | MA | HARVARD PILGRIM |
| M18034 | Other | MA | BLUE SHIELD |
Other providers in Attleboro, MA
- Pamela G Atanasoff
- Attleboro Anesthesia, Inc.
- Attleboro Chiropractic Health Center Inc.
- Attleboro Counseling Associates, Inc.
- Attleboro Dental Arts PC
- Attleboro Gastroenterology, PC
- Attleboro Internal Medicine, P.C.
- Attleboro Lodge, Inc
- Attleboro Medical Investors LP
- Attleboro Ophthalmological Associates Inc
All providers in Attleboro, MA · Dermatology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2009. 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.
- 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.