MYSTIC VALLEY MASS, PC - NPI 1184377343 - Dermatology in Stoneham, MA

Q: What is Mystic Valley Mass, PC's NPI number?

The NPI number for Mystic Valley Mass, PC is 1184377343. It was assigned to this organization in the NPPES registry on January 28, 2022.

Q: What is Mystic Valley Mass, PC's specialty?

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

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About Mystic Valley Mass, Pc NPPES

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

MYSTIC VALLEY MASS, PC (NPI 1184377343) is a healthcare organization registered as a dermatology in Stoneham, Massachusetts and active in the NPI registry since January 2022. The organization holds a CLIA Certificate of Compliance certificate valid through March 25, 2028 and lists Samuel Goos, Owner, as its authorized official.

NPPES Registry Identity

NPI1184377343

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameMYSTIC VALLEY MASS, PC

Location Address92 MONTVALE AVE STE 3000Stoneham, MA 02180-3658

Mailing Address526 Main St Ste 302Acton, MA 01720-3301 · (978) 371-7010

Phone(781) 438-6350

Organization SubpartYesParent: Mystic Valley Dermatology Associates, P.c.

Authorized OfficialSamuel GoosOwner · (783) 717-0109

Enumeration DateJanuary 28, 2022

NPPES CertifiedJanuary 28, 2022

✔ NPI 1184377343 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.

92 MONTVALE AVE STE 3000, Stoneham, MA 02180

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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 22D1015174

Mystic Valley Dermatology Associates · Stoneham, MA

Active · expires Mar 25, 2028

CLIA Number22D1015174

Laboratory TypePhysician Office

Certificate Effective DateMarch 26, 2026

Certificate Expiration DateMarch 25, 2028

Laboratory DirectorDonald J. Grande

Laboratory Phone(781) 438-6350

Laboratory LocationMystic Valley Dermatology Associates92 Montvale Ave Ste 3000, Stoneham, MA 02180

CLIA data matches this NPI record on: Address Phone

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 7

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

DR. DONALD J. GRANDE MD

Dermatology