SOUTH SHORE MEDICAL CENTER, INC
NPI 1033778824
Dermatology in Norwell, MA

Q: What is South Shore Medical Center, Inc's NPI number?

The NPI number for South Shore Medical Center, Inc is 1033778824. It was assigned to this organization in the NPPES registry on June 6, 2019.

Q: What is South Shore Medical Center, Inc's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since June 06, 2019CLIA Certified · 3 labs

143 LONGWATER DR, NORWELL, MA 02061(781) 878-5200 Get Directions Write a Review

NPPES record last updated: January 23, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 1, 2023, Nov 11, 2022, Jun 6, 2019 (3 updates tracked since 2019).

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About South Shore Medical Center, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH SHORE MEDICAL CENTER, INC (NPI 1033778824) is a healthcare organization registered as a dermatology in Norwell, Massachusetts and active in the NPI registry since June 2019. The organization holds 3 active CLIA laboratory certificates, maintains 5 additional practice locations, and lists Jaclyn Valanzola, Credentialing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1033778824

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameSOUTH SHORE MEDICAL CENTER, INC

Location Address143 LONGWATER DRNorwell, MA 02061-1683

Mailing Address141 Longwater DrNorwell, MA 02061-1632 · (781) 792-4136

Phone(781) 878-5200

Organization SubpartNo

Authorized OfficialJaclyn ValanzolaCredentialing Supervisor · (781) 681-0384

Enumeration DateJune 6, 2019

Last NPPES UpdateJanuary 23, 20243 updates tracked since enumeration

NPPES CertifiedMarch 9, 2023

✔ NPI 1033778824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 10

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedAllergy & Immunology · AllergyTaxonomy 207KA0200X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X

Also ListedPediatricsTaxonomy 208000000X

Also ListedUrologyTaxonomy 208800000X

Also ListedGeneral PracticeTaxonomy 208D00000X

Also ListedPodiatristTaxonomy 213E00000X

143 LONGWATER DR, Norwell, MA 02061

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Secondary Practice Locations 5

Location 11495 Hancock StQuincy, MA 02169-5229 · Phone (781) 878-5200

Location 2780 Main St Ste 2CWeymouth, MA 02190-1618 · Phone (781) 341-4600

Location 3340 Wood RdBraintree, MA 02184-2401 · Phone (781) 878-5200

Location 45 Tarkiln RdKingston, MA 02364-1250 · Phone (781) 585-2200

Location 551 Performance DrWeymouth, MA 02189-3141 · Phone (781) 682-8000

Other Identifiers 1

Medicaid1669411856MA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2172069

South Shore Medical Center · Quincy, MA

Active · expires Sep 12, 2027

CLIA Number22D2172069

Laboratory TypePhysician Office

Certificate Effective DateSeptember 13, 2025

Certificate Expiration DateSeptember 12, 2027

Laboratory DirectorPeter J. Ferlisi

Laboratory Phone(781) 261-7891

Laboratory LocationSouth Shore Medical Center1495 Hancock St, Quincy, MA 02169

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 22D0080186

South Shore Medical Center Kingston · Kingston, MA

Active · expires Jun 27, 2027

CLIA Number22D0080186

Laboratory TypePhysician Office

Certificate Effective DateJune 28, 2025

Certificate Expiration DateJune 27, 2027

Laboratory DirectorPeter Ferlisi

Laboratory Phone(781) 582-2635

Laboratory LocationSouth Shore Medical Center Kingston5 Tarkiln Road, Kingston, MA 02364

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 22D2005448

South Shore Medical Center Part Of South Shore Health System · Norwell, MA

Active · expires May 8, 2027

CLIA Number22D2005448

Laboratory TypePhysician Office

Certificate Effective DateMay 9, 2025

Certificate Expiration DateMay 8, 2027

Laboratory DirectorPeter Ferlisi

Laboratory Phone(781) 624-8770

Laboratory LocationSouth Shore Medical Center Part Of South Shore Health System143 Longwater Drive, Norwell, MA 02061

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KHALIL ALLEYNE MD

Family Medicine