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SOUTH COAST DERMATOLOGY LLC
NPI 1215911383
Specialist in Weymouth, MA

Active since December 02, 2005CLIA 22D0998328 · Certificate of Compliance
90 LIBBEY PKWY, SUITE 200, WEYMOUTH, MA 02189(781) 335-9700(781) 335-9709 Get Directions Write a Review

NPPES record last updated: February 22, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About South Coast Dermatology Llc NPPES

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

SOUTH COAST DERMATOLOGY LLC (NPI 1215911383) is a healthcare organization registered as a specialist in Weymouth, Massachusetts and active in the NPI registry since December 2005. The organization holds a CLIA Certificate of Compliance certificate valid through December 25, 2027 and lists Teresa Degiacomo, Medical Doctor, as its authorized official.

NPPES Registry Identity

NPI1215911383
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTH COAST DERMATOLOGY LLC
Location Address90 LIBBEY PKWY, SUITE 200Weymouth, MA 02189-3100
Mailing Address90 Libbey Pkwy, Suite 200Weymouth, MA 02189-3100 · (781) 335-9700 · Fax (781) 335-9709
Phone(781) 335-9700
Fax(781) 335-9709
Organization SubpartNo
Authorized OfficialTeresa DegiacomoMedical Doctor · (781) 335-9700
Enumeration DateDecember 2, 2005
Last NPPES UpdateFebruary 22, 2018
✔ NPI 1215911383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
90 LIBBEY PKWY, Weymouth, MA 02189
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Other Identifiers 3

Medicaid9713361MA
Other691531Tufts
OtherM17965Bc/bs

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)

South Coast Dermatology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to South Coast Dermatology LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.

Clinicians by Medicare Specialty 4

Dermatology6
Pathology3
Micrographic Dermatologic Surgery (MDS)1
Nurse Practitioner1

Clinicians, nearest first (11)

Heidi Anderson-Dockter, M.D.
Dermatology
NPI 1417256314
90 LIBBEY PKWY SUITE 200
Weymouth, MA 02189
(781) 335-9700
✔ PECOS✔ Accepts MedicareSame address
Karen Borden, NP
Nurse Practitioner
NPI 1548347982
90 LIBBEY PKWY SUITE 200
Weymouth, MA 02189
(781) 335-9700
✔ PECOS✔ Accepts MedicareSame address
Courtney Csikesz, M.D.
Dermatology
NPI 1760619902
90 LIBBEY PKWY SUITE 200
Weymouth, MA 02189
(781) 335-9700
✔ PECOS✔ Accepts MedicareSame address
Susan Decoste, M.D.
Dermatology
NPI 1942284591
90 LIBBEY PKWY SUITE 200
Weymouth, MA 02189
(781) 335-9700
✔ PECOS✔ Accepts MedicareSame address
Teresa Degiacomo, M.D.
Dermatology
NPI 1245214311
90 LIBBEY PKWY SUITE 200
Weymouth, MA 02189
(781) 335-9700
✔ PECOS✔ Accepts MedicareSame address
Lauren Strazzula, M.D.
Dermatology
NPI 1598178923
1 SCOBEE CIR STE 3
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare21 mi
Hongmei Li, M.D.,PH.D.
Pathology
NPI 1184600017
32 ROCKPORT RD
Weston, MA 02493
(617) 254-7284
✔ PECOS✔ Accepts Medicare21 mi
Jennifer Lambe, MD
Pathology
NPI 1487803235
1 CRANBERRY HL SUITE #303
Lexington, MA 02421
(781) 290-0057
✔ PECOS✔ Accepts Medicare24 mi
Michael Shaughnessy, MD
Micrographic Dermatologic Surgery (MDS)
NPI 1235767849
8 MARKET XING
Plymouth, MA 02360
(508) 224-3800
✔ PECOS✔ Accepts Medicare26 mi
Beatriz Tapia-Centola, MD
Pathology
NPI 1770502908
1 CRANBERRY HL SUITE 303
Lexington, MA 02421
(781) 290-0057
✔ PECOS✔ Accepts Medicare33 mi
Jennifer Kane, MD
Dermatology
NPI 1528598760
621 S NEW BALLAS RD STE 498A
Creve Coeur, MO 63141
(314) 251-3376
✔ PECOS✔ Accepts Medicare1,054 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 22D0998328

South Coast Dermatology · Weymouth, MA
Active · expires Dec 25, 2027
CLIA Number22D0998328
Laboratory TypePhysician Office
Certificate Effective DateDecember 26, 2025
Certificate Expiration DateDecember 25, 2027
Laboratory DirectorDr. Heidi Anderson-Dockter
Laboratory Phone(781) 335-9700
Laboratory LocationSouth Coast Dermatology97 Libbey Industrial Parkway, Suite 400, Weymouth, MA 02189
CLIA data matches this NPI record on: Name Phone
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 South Coast Dermatology LLC's NPI number?

The NPI number for South Coast Dermatology LLC is 1215911383. It was assigned to this organization in the NPPES registry on December 2, 2005.

Where is South Coast Dermatology LLC located?

South Coast Dermatology LLC is located at 90 Libbey Pkwy Suite 200, Weymouth, MA 02189. The listed phone number is (781) 335-9700.

What is South Coast Dermatology LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is South Coast Dermatology LLC enrolled in Medicare?

Yes. South Coast Dermatology LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through South Coast Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 4 Medicare specialties reassign their Medicare billing to South Coast Dermatology 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 (6), Pathology (3) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does South Coast Dermatology LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 22D0998328) is associated with this NPI, valid through December 25, 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 South Coast Dermatology LLC was last updated on February 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.