NPIMap

Organization Active NPI

Coastal Apderm Mass, LLC

  • Dermatology Physician
  • Westport, MA
National Provider Identifier
1871236471
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
COASTAL APDERM MASS, LLC
Practice address
829 American Legion Hwy
Westport, MA 02790-4128
Phone
(978) 371-7010
NPI assigned
Apr 20, 2022
Last updated
Apr 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
COASTAL DERMATOLOGY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Authorized official

Name
Samuel GoosNPI 1548240039
Title
Owner
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

829 American Legion Hwy
Westport, MA 02790-4128

Mailing address

526 Main St Ste 302
Acton, MA 01720-3301
Phone (978) 371-7010

National Provider Directory

National Provider Directory
Part of
Coastal Dermatology Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1871236471",
    "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": "829 AMERICAN LEGION HWY",
            "city": "WESTPORT",
            "state": "MA",
            "postal_code": "027904128",
            "telephone_number": "978-371-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL APDERM MASS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL DERMATOLOGY INC",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "GOOS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-371-7010"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.