INTEGRATED DERMATOLOGY OF BROOKLINE, LLC
NPI 1104389154
Dermatology in Brookline, MA
About Integrated Dermatology Of Brookline, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INTEGRATED DERMATOLOGY OF BROOKLINE, LLC (NPI 1104389154) is a healthcare organization registered as a dermatology in Brookline, Massachusetts and active in the NPI registry since April 2019. The organization holds a CLIA Certificate of Compliance certificate valid through April 13, 2027 and lists Adam S Plotkin, Authorized Group Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Integrated Dermatology Of Brookline, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Integrated Dermatology Of Brookline, LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
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 Compliance 22D2173228
Integrated Dermatology Of Brookline · Brookline, MAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Integrated Dermatology Of Brookline, LLC's NPI number?
The NPI number for Integrated Dermatology Of Brookline, LLC is 1104389154. It was assigned to this organization in the NPPES registry on April 8, 2019.
Where is Integrated Dermatology Of Brookline, LLC located?
Integrated Dermatology Of Brookline, LLC is located at 1101 Beacon St Ste 1E, Brookline, MA 02446. The listed phone number is (617) 731-2390.
What is Integrated Dermatology Of Brookline, LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Integrated Dermatology Of Brookline, LLC enrolled in Medicare?
Yes. Integrated Dermatology Of Brookline, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Integrated Dermatology Of Brookline, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Integrated Dermatology Of Brookline, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (3) and Nurse Practitioner (1). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Integrated Dermatology Of Brookline, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 22D2173228) is associated with this NPI, valid through April 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Integrated Dermatology Of Brookline, LLC accept?
Health plans from Anthem Blue Cross and Blue Shield list Integrated Dermatology Of Brookline, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Integrated Dermatology Of Brookline, LLC was last updated on April 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Integrated Dermatology Of Brookline, Llc · NPI 1104389154
Dermatology organization in Brookline, Massachusetts. Organization record, active in the CMS NPPES registry since April 8, 2019.
## Identity
- **NPI:** 1104389154 (Entity type: Organization)
- **Enumerated:** April 8, 2019
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Adam Plotkin, AUTHORIZED GROUP OFFICIAL
## Practice location
- **Address:** 1101 BEACON ST STE 1E, Brookline, MA 02446-5587
- **Phone:** (617) 731-2390
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (3), Nurse Practitioner (1); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 8, 2019
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104389154) · Data from the CMS NPPES public registry.