Individual provider Active NPI

Lynne J Goldberg, MD

  • Dermatology Physician
  • Boston, MA
National Provider Identifier
1861483018
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
75274 Issued in MA
Practice address
725 Albany St
Shapiro 8
Boston, MA 02118-2526
Phone
(617) 638-7420
Fax
(617) 638-7289
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X 75274 MA
Dermatology Physician 207N00000X 75274 MA Primary

Addresses

Primary practice location

725 Albany St
Shapiro 8
Boston, MA 02118-2526

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

Other practice location 1

1822 N Main St Ste 302
Fall River, MA 02720-1350
Phone (508) 235-1118

Other identifiers 1

IdentifierTypeStateIssuer
110053989AMedicaidMA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050601000188 MA Practitioner - Dermatology 1456393453 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75274MAMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratory of Dermatopathology Adx, LLC CurrentSince Jul 4, 2026 Accepting new patients
Dermpath New England, LLC CurrentSince Jul 17, 2025 Accepting new patients
Boston University Mallory Pathology Associates, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Child Health Foundation of Boston, Inc. PastSince Jan 1, 2005 Accepting new patients
Evans Medical Foundation, Inc. Past Accepting new patients
New England Tissue Issue, PLLC Dermatopathology Past Accepting new patients

Locations

670 Albany St
Ste 3
Boston, MA 02118
Phone (617) 414-4291

1380 Soldiers Field Rd
Ste 3800
Brighton, MA 02135
Phone (617) 254-7284

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

80 Crossways Park Dr
Ste 100
Woodbury, NY 11797
Phone (516) 944-3882

1355 River Bend Dr
Dallas, TX 75247
Phone (214) 237-1818

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1861483018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST",
            "address_2": "SHAPIRO 8",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182526",
            "telephone_number": "617-638-7420",
            "fax_number": "617-638-7289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1822 N Main St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027201350",
            "country_code": "US",
            "telephone_number": "508-235-1118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "LYNNE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "MA",
            "license": "75274",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "75274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110053989A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.