NORTHEAST DERMATOLOGY ASSOCIATES – Dermatology Physician, NPI 1669844163
Dermatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NORTHEAST DERMATOLOGY ASSOCIATES
538 TURNPIKE ST
NORTH ANDOVER, MA 018455812
Phone: (978) 691-5690
Fax: (978) 691-5693
Type: Location
280 MERRIMACK ST STE 311
LAWRENCE, MA 018431779
Phone: (978) 691-5690
Fax: (978) 691-5693
Type: Mailing
198 Massachusetts Ave Ste 105
North Andover, MA 018454143
Phone: (978) 691-5690
Fax: (978) 691-5693
Type: Location
138 Conant St
Beverly, MA 019151665
Phone: (978) 691-5690
Fax: (978) 691-5693
Type: Location
1 Blackburn Dr
Gloucester, MA 019302292
Phone: (978) 691-5690
Fax: (978) 691-5693
Type: Location
62 Brown St Ste 304C
Haverhill, MA 018306790
Phone: (978) 691-5690
Fax: (978) 691-5693
Type: Location
1 Wallace Bashaw Way Ste 1002
Newburyport, MA 019503876
Phone: (978) 691-5690
Fax: (978) 691-5693
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: 2018-01-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (742 days ago).
Enrollment records
1
Earliest due date
2024-05-31
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 |
|---|---|---|---|---|
| O20180122000100 | O | Clinic/Group Practice | MA | 2024-05-31 |
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 01845)
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