BOSTON PLASTIC SURGERY ASSOCIATES, PC – Plastic Surgery Physician, NPI 1417955402
Plastic Surgery Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for BOSTON PLASTIC SURGERY ASSOCIATES, PC
340, Main Street, Leominster, Worcester County, Massachusetts, 01453, United States
STE. 670
WORCESTER, MA 016081604
Phone: (508) 754-3566
Fax: (508) 438-6364
Type: Mailing
Brigham & Women's Faulkner Hospital, 1153, Centre Street, Jamaica Plain, Boston, Suffolk County, Massachusetts, 02130, United States
SUITE 5790
BOSTON, MA 021303446
Phone: (617) 522-0008
Fax: (617) 522-2587
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: 2010-02-17
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-12-31 (167 days ago).
Enrollment records
1
Earliest due date
2025-12-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100217000579 | O | Clinic/Group Practice | MA | 2025-12-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 01608)
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