SOUTH COAST DERMATOLOGY LLC (NPI# 1215911383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215911383 |
| Entity Type | Organization |
| Organization Name | SOUTH COAST DERMATOLOGY LLC |
| Practice Address |
90 Libbey Pkwy Suite 200 Weymouth MA 02189-3100 |
| Practice Telephone | 7813359700 |
| Practice Fax Number | 7813359709 |
| Mailing Telephone | 7813359700 |
| Mailing Fax Number | 7813359709 |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | TERESA DEGIACOMO (MEDICAL DOCTOR) |
| Authorized Official Telephone | 7813359700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 9713361 | 05 | |
| TUFTS | 691531 | 01 | |
| BC/BS | M17965 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114567377 | South Coast Dermatology LLC | Nurse Practitioner | 620 Commercial Ave, Coos Bay, OR 97420-1846 | 2020-01-15 |
| Street Address |
90 LIBBEY PKWY SUITE 200 |
| City | WEYMOUTH |
| State | MA |
| Zip Code | 02189-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316928013 | Donna J Gensheimer | Nurse Practitioner | 90 Libbey Pkwy, Suite 200, Weymouth, MA 02189-3129 | 2005-11-09 |
| 1184176810 | Elizabeth Lopes-costa | Nurse Practitioner | 90 Libbey Pkwy, Weymouth, MA 02189 | 2016-10-28 |
| 1972910875 | Katharine Berrio | Specialist/Technologist | 90 Libbey Pkwy, Suite 103, Weymouth, MA 02189-3129 | 2014-07-13 |
| 1760818116 | Granite Medical Group, Inc | Internal Medicine | 90 Libbey Pkwy, Suite 201, Weymouth, MA 02189-3129 | 2013-09-17 |
| 1497008155 | Christine Bitetti | Physician Assistant | 90 Libbey Pkwy, Suite 200, Weymouth, MA 02189-3129 | 2012-10-18 |
| 1063797512 | Alicia Van Cott | Nurse Practitioner | 90 Libbey Pkwy, Suite 200, Weymouth, MA 02189-3129 | 2011-10-17 |
| 1417256314 | Heidi Flora Anderson-dockter | Dermatology | 90 Libbey Pkwy, Suite 200, Weymouth, MA 02189-3129 | 2011-03-18 |
| 1497085831 | Loren G. Fickies | Obstetrics & Gynecology | 90 Libbey Pkwy, Suite 105, Weymouth, MA 02189-3129 | 2010-01-07 |
| 1457688756 | Janelle Murphy | Obstetrics & Gynecology | 90 Libbey Pkwy, Weymouth, MA 02189-3129 | 2009-11-06 |
| 1760619902 | Courtney Reilly Csikesz | Dermatology | 90 Libbey Pkwy, Suite 200, Weymouth, MA 02189-3129 | 2009-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205300985 | M. Taylor Fontneau | Nurse Practitioner | 90 Libbey Industrial Pkwy Ste 106, Weymouth, MA 02189 | 2019-01-16 |
| 1336668011 | Svetlana Chentsova | Nurse Practitioner | 51 Performance Dr Fl Drive, Weymouth, MA 02189 | 2017-09-14 |
| 1518487818 | Dana Shepherd | Specialist/Technologist | 163 Libbey Industrial Parkway, Suite 302, Weymouth, MA 02189 | 2017-06-27 |
| 1063867802 | Gerald F. Finerty IIi | Nurse Anesthetist, Certified Registered | 163 Libbey Pkwy Ste 301, Weymouth, MA 02189 | 2016-04-29 |
| 1417326604 | Ocean State Urgent Care | Physician Assistant | 119 Liberty Bell Cir, Weymouth, MA 02189 | 2015-09-18 |
| 1558746636 | Jaime Hill | Nurse Practitioner | 31 Charles Street, Weymouth, MA 02189 | 2015-07-30 |
| 1780865337 | James Tyler Carpenter | Psychologist | Neurobehavioral Associates, 169 Libbey Parkway, 2nd Floor, Weymouth, MA 02189 | 2007-11-23 |
| 1508054248 | Anita Nathan Shukla | Ophthalmology | 97 Libbey Industrial Parkway, Suite 100, E. Weymouth, MA 02189 | 2007-10-09 |
| 1164618757 | Mahesh Pandey | Internal Medicine | Dana Farber Community Cancer Care, 51 Performance Drive, Suite 110, Weymouth, MA 02189 | 2007-09-18 |
| 1750573887 | Michele Donlon | Speech-Language Pathologist | 163 Libbey Industrial Pkwy Ste 302, Weymouth, MA 02189 | 2007-08-13 |
| Find all providers in zip 02189 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124478219 | Jacqueline Stockton | Specialist | 273 West St, Weymouth, MA 02188-1116 | 2016-06-20 |
| 1790996494 | Kendall V. Bretto | Specialist | 98 Commercial St, 2r, Weymouth, MA 02188-2605 | 2007-05-24 |
| 1396297057 | Ann Richardson | Specialist | 163 Libbey Industrial Pkwy, Suite 302, Weymouth, MA 02189-3137 | 2016-10-28 |
| 1568917870 | Nancy Hansen | Specialist | 163 Libbey Industrial Pkwy, Suite 302, Weymouth, MA 02189 | 2016-08-17 |
| 1235590621 | Joyce M Sullivan | Specialist | 574 Main St, Weymouth, MA 02190-1818 | 2016-03-11 |
| 1619220548 | Roberta Jean Hill | Specialist | 94 Washington St, Suite #8, Weymouth, MA 02188-1721 | 2012-10-16 |
| 1386847275 | Neurology Consultants, PC | Specialist | 90 Libbey Industrial Pkwy, Suite 102, Weymouth, MA 02189-3129 | 2007-06-07 |
| 1295859445 | South Suburban Neurosurgical Associates | Specialist | 780 Main St, Weymouth, MA 02190-1622 | 2007-03-16 |
| 1912095308 | Natov Medical Associates, PC | Specialist | 851 Main St, Suite 10, Weymouth, MA 02190-1612 | 2006-10-11 |
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| 1811595440 | Elite Upper Extremity and Plastic Surgery, Pllc | Specialist | 123 Summer St Ste 550, Worcester, MA 01608-1216 | 2020-10-15 |
| 1285272559 | Michael Anthony Mandella | Specialist | 615 Reservoir Rd, Lunenburg, MA 01462-1540 | 2019-12-17 |
| 1003372996 | Pic A Nit LLC | Specialist | 111 Worcester Street, North Grafton, MA 01536 | 2019-02-15 |
| 1427513738 | Arlene L Casassa | Specialist | 271 Pond St, Hopkinton, MA 01748-1509 | 2019-01-31 |
| 1851881767 | Cheryl Ann Borden | Specialist | 51 Country Club Way, Ipswich, MA 01938-3000 | 2018-05-16 |
| 1518469089 | Kathleen L Golemon | Specialist | 100 Cummings Center Suite 158-d, Beverly, MA 01915 | 2018-03-01 |
| 1114426988 | Louise Berit Homstead | Specialist | 108 N Main St Ste A, Sunderland, MA 01375-9502 | 2018-02-07 |
| 1356859425 | Tanya Elaine Lachowicz | Specialist | 19 Agassiz St Apt 1, Cambridge, MA 02140-2826 | 2018-01-11 |
| 1083126338 | Kailash Nagrath | Specialist | 33 Sequattom Road, Harwich, MA 02645 | 2017-10-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.