Individual provider Active NPI

Thomas Cooper, M.D.

Dermatology Physician
Wellesley, MA

National Provider Identifier

1932106572

Registry record updated Nov 24, 2020

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
NPI Registry JSON
Other providers in Wellesley, MA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Dermatology PhysicianTaxonomy code 207N00000X
License: 55056 Issued in MA
Practice address: 230 Worcester St
Wellesley, MA 02481-5420
Phone: (781) 431-5255
Fax: (781) 431-5329
NPI assigned: Jun 28, 2005
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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
Dermatology Physician	207N00000X	55056	MA	Primary

Addresses

Primary practice location

230 Worcester St
Wellesley, MA 02481-5420

Mailing address

230 Worcester St
Wellesley, MA 02481-5420
Phone (781) 431-5255

Other identifiers 18

Identifier	Type	Issuer
055056	Other	TUFTS SECURE HORIZONS
27422	Other	CHILDREN'S MEDICAL SECURI
J04908	Other	BLUE SHIELD INDEMNITY
055056	Other	TUFTS
4434	Other	HARVARD PILGRIM PPO
B87206	Other	FIRST SENIORITY
055056	Other	TUFTS BENEFIT ADMIN
055056	Other	TUFTS COMMONWELATH
070003328	Other	RAILROAD MEDICARE
6692873	Other	CIGNA HEALTH CARE
J04908	Other	BS-BLUSE CARE ELECT
0016756	Other	NEIGHBORHOOD HEALTH PLAN
055056	Other	TUFTS TOTAL HEALTH PLAN
4434	Other	HARVARD PILGRIM POS
401052	Other	HARVARD/PILGRIM
6174167	Other	MASS HEALTH
6692873	Other	HEALTHSOURCE-MA
J04908	Other	HMO BLUE/BLUE CHOICE

Electronic endpoints 1

Type	Endpoint	Use	Affiliation
Direct Messaging Address	tcoopermd15533@direct.atrius.masshiway.net

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Enrolled
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
55056	MA	MD	Dermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1932106572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815420",
            "telephone_number": "781-431-5255",
            "fax_number": "781-431-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024815420",
            "telephone_number": "781-431-5255",
            "fax_number": "781-431-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "55056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS SECURE HORIZONS",
            "identifier": "055056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDREN'S MEDICAL SECURI",
            "identifier": "27422",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "J04908",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "055056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM PPO",
            "identifier": "4434",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST SENIORITY",
            "identifier": "B87206",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS BENEFIT ADMIN",
            "identifier": "055056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS COMMONWELATH",
            "identifier": "055056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070003328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH CARE",
            "identifier": "6692873",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS-BLUSE CARE ELECT",
            "identifier": "J04908",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0016756",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS TOTAL HEALTH PLAN",
            "identifier": "055056",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM POS",
            "identifier": "4434",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD/PILGRIM",
            "identifier": "401052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH",
            "identifier": "6174167",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE-MA",
            "identifier": "6692873",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE/BLUE CHOICE",
            "identifier": "J04908",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tcoopermd15533@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "230 Worcester St",
            "city": "Wellesley",
            "state": "MA",
            "country_code": "US",
            "postal_code": "024815420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.