ISHA TIERNAN (M.D.) – Dermatology Physician, NPI 1164804928

ISHA TIERNAN (M.D.) is a healthcare provider. based in Boston, Massachusetts. specializing in DERMATOLOGY. They hold the professional credentials M.D.. They hold a License No. LP03600 (RI). The NPI Number for ISHA TIERNAN (M.D.) is 1164804928

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
ISHA TIERNAN (M.D.)
NPI
1164804928
Phone
(617) 636-5000
Address
Tufts Medical Center
Enumeration Date
29 June 2015
Last Update Date
16 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6176365000
Graduation Year
2015 (11 years ago)
PAC ID
1658666797
Group Practice PAC ID
6305737511
Professional Enrollment ID
I20190903001058
Address ID
MA021111552BO800XXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:10State licenses:3Digital endpointsOther names

744 DERMATOLOGY in MA

Provider Addresses for ISHA TIERNAN (M.D.)

  • Tufts Medical Center

    800 Washington Street

    Boston, MA 02111

    Phone: (617) 636-5000

    Type: Location

  • 19 CASTLE RD

    NORTHBOROUGH, MA 015321248

    Phone:

    Type: Mailing

  • TUFTS MEDICAL CENTER

    800 WASHINGTON STREET

    BOSTON, MA 02111

    Phone: (617) 636-5000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-09-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190903001058IDermatologyMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths29770$0
99213Established patient office or other outpatient visit, 20-29 minutes170136$0
17000Destruction of precancer skin growth, 1 growth11286$0
99214Established patient office or other outpatient visit, 30-39 minutes10086$0
11102Biopsy of related skin growth, first growth6050$0
View full utilization report →

Insurance plans in this area (ZIP 02111)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305737511View full group profile
NameSpecialtyState
D E R M A T O L O G YTN
D E R M A T O L O G YNY
D E R M A T O L O G YMA
D E R M A T O L O G YFL
D E R M A T O L O G YMA
D E R M A T O L O G YPA
D E R M A T O L O G YMA
D E R M A T O L O G YMA
D E R M A T O L O G YMA
D E R M A T O L O G YLA

Reviews

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Frequently asked questions

How do payers reference ISHA TIERNAN (M.D.)?
For ISHA TIERNAN (M.D.), use NPI 1164804928 as the unique 10-digit identifier.
Is there an active status for ISHA TIERNAN (M.D.)?
For scheduling context, ISHA TIERNAN (M.D.) is shown as active in the registry.
What expertise is attributed to ISHA TIERNAN (M.D.)?
ISHA TIERNAN (M.D.)'s specialty line reads Dermatology Physician. Clinical services aligned with this taxonomy classification.
Where in Massachusetts is ISHA TIERNAN (M.D.) registered?
Use Boston, Massachusetts as the headline location for ISHA TIERNAN (M.D.) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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