Active NPI
Richard Franklin Eisen, MD
- Dermatology Physician
- Boston, MA
National Provider Identifier
1992700728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 48498
- Practice address
- 725 Albany St # 8B
Boston, MA 02118-3549 - Phone
- (617) 638-7420
- Fax
- (617) 638-7289
- NPI assigned
- Jun 17, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | 48498 | MA | |
| Dermatology Physician | 207N00000X | 48498 | MA | Primary |
Addresses
Primary practice location
725 Albany St # 8B
Boston, MA 02118-3549
Mailing address
801 Albany St FL G
Boston, MA 02119-3791
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37336 | Other | MA | UNICARE |
| 4274478 | Other | MA | AETNA |
| 03-00291 | Other | MA | UNITED HEALTHCARE |
| 4032 | Other | MA | HARVARD PILGRIM |
| 509211 | Other | MA | FALLON HEALTHCARE |
| B202877 | Other | MA | CIGNA HEALTHCARE |
| 712907 | Other | MA | TUFTS HEALTH PLAN |
| E05971 | Other | MA | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48498 | MA | MD | MOHS-Micrographic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Shore Skin Center | Dermatology | Current | Accepting new patients |
Locations
75 Washington St
Norwell, MA 02061
1 Scobee Cir
Ste 3
Plymouth, MA 02360
Phone (508) 747-0711
Organizations & group practices 1
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.
-
- Dermatology Physician
- Norwell, MA
- NPI 1366805335
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632873600000",
"number": "1992700728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 ALBANY ST FL G",
"city": "BOSTON",
"state": "MA",
"postal_code": "021193791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 ALBANY ST # 8B",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183549",
"telephone_number": "617-638-7420",
"fax_number": "617-638-7289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISEN",
"first_name": "RICHARD",
"middle_name": "FRANKLIN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-17",
"last_updated": "2021-09-29",
"certification_date": "2021-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "MA",
"license": "48498",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MA",
"license": "48498",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNICARE",
"identifier": "37336",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4274478",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "03-00291",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "4032",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON HEALTHCARE",
"identifier": "509211",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "B202877",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "712907",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "E05971",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.