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PLYMOUTH DERMATOLOGY ASSOCIATES, PC
NPI 1144362179
Dermatology in Plymouth, MA

Active since February 13, 2007CLIA 22D2263222 · Certificate of Compliance
345 COURT ST, SUITE 201, PLYMOUTH, MA 02360(508) 746-5300(508) 747-2001 Get Directions Write a Review

NPPES record last updated: May 5, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Plymouth Dermatology Associates, Pc NPPES

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

PLYMOUTH DERMATOLOGY ASSOCIATES, PC (NPI 1144362179) is a healthcare organization registered as a dermatology in Plymouth, Massachusetts and active in the NPI registry since February 2007. The organization holds a CLIA Certificate of Compliance certificate valid through November 2, 2027 and lists Jeffrey N Farber, Vice President, as its authorized official.

NPPES Registry Identity

NPI1144362179
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePLYMOUTH DERMATOLOGY ASSOCIATES, PC
Location Address345 COURT ST, SUITE 201Plymouth, MA 02360-4329
Mailing Address345 Court St, Suite 201Plymouth, MA 02360-4329 · (508) 746-5300 · Fax (508) 747-2001
Phone(508) 746-5300
Fax(508) 747-2001
Organization SubpartNo
Authorized OfficialJeffrey N FarberVice President · (508) 746-5300
Enumeration DateFebruary 13, 2007
Last NPPES UpdateMay 5, 2008
✔ NPI 1144362179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
345 COURT ST, Plymouth, MA 02360
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Other Identifiers 3

OtherM16586MA · Blue Cross And Blue Shield
Medicare PINM20298MA
OtherCN6573MA · Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Plymouth Dermatology Associates, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Plymouth Dermatology Associates, PC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Kathleen Brodt, NURSE PRACTITIONER
Nurse Practitioner
NPI 1821264847
345 COURT ST SUITE 201
Plymouth, MA 02360
(508) 746-5300
✔ PECOS✔ Accepts MedicareSame address
Anne-Sophie Gadenne, MD
Dermatology
NPI 1891850343
345 COURT ST SUITE 202
Plymouth, MA 02360
(508) 746-5300
✔ PECOS✔ Accepts MedicareSame address
Russell Phayre, FNP-BC
Nurse Practitioner
NPI 1952101420
345 COURT ST STE 210
Plymouth, MA 02360
(508) 746-5300
✔ PECOS✔ Accepts MedicareSame address
Kenneth Yu, M.D., PH.D.
Micrographic Dermatologic Surgery (MDS)
NPI 1811302359
345 COURT ST STE 201
Plymouth, MA 02360
(508) 746-5300
✔ PECOS✔ Accepts MedicareSame address
Chelsea Culhane
Nurse Practitioner
NPI 1063175966
102 VALLEY RD
Middletown, RI 02842
(401) 239-1800
✔ PECOS✔ Accepts Medicare45 mi
Victoria Lazareth, NP
Nurse Practitioner
NPI 1497729297
100 FODEN RD STE 203
South Portland, ME 04106
(207) 523-3900
✔ PECOS✔ Accepts Medicare116 mi

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 22D2263222

Plymouth Dermatology Associates, PC · Plymouth, MA
Active · expires Nov 2, 2027
CLIA Number22D2263222
Laboratory TypePhysician Office
Certificate Effective DateNovember 3, 2025
Certificate Expiration DateNovember 2, 2027
Laboratory DirectorDr. Kenneth K. Yu
Laboratory Phone(508) 364-0174
Laboratory LocationPlymouth Dermatology Associates, PC345 Court Street, Suite 301, Plymouth, MA 02360
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.

Frequently 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 Plymouth Dermatology Associates, PC's NPI number?

The NPI number for Plymouth Dermatology Associates, PC is 1144362179. It was assigned to this organization in the NPPES registry on February 13, 2007.

Where is Plymouth Dermatology Associates, PC located?

Plymouth Dermatology Associates, PC is located at 345 Court St Suite 201, Plymouth, MA 02360. The listed phone number is (508) 746-5300.

What is Plymouth Dermatology Associates, PC's specialty?

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

Is Plymouth Dermatology Associates, PC enrolled in Medicare?

Yes. Plymouth Dermatology Associates, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Plymouth Dermatology Associates, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Plymouth Dermatology Associates, PC. 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 Nurse Practitioner (4), Dermatology (1) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Plymouth Dermatology Associates, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 22D2263222) is associated with this NPI, valid through November 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Plymouth Dermatology Associates, PC was last updated on May 5, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.