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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BOSTON DERMATOLOGY AND LASER CENTER, LLC
NPI 1215963574
Dermatology in Boston, MA

Active since June 25, 2006
30 LANCASTER STREET, SUITE 400, BOSTON, MA 02114(617) 722-4100(617) 227-1134 Get Directions Write a Review

NPPES record last updated: October 6, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 6, 2026, May 23, 2025, Jun 21, 2019 and 1 more (4 updates tracked since 2019).

About Boston Dermatology And Laser Center, Llc NPPES

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

BOSTON DERMATOLOGY AND LASER CENTER, LLC (NPI 1215963574) is a healthcare organization registered as a dermatology in Boston, Massachusetts and active in the NPI registry since June 2006. The organization maintains a secondary practice location in Cambridge and lists Samuel D Goos, Owner/managing Partner, as its authorized official.

NPPES Registry Identity

NPI1215963574
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBOSTON DERMATOLOGY AND LASER CENTER, LLC
Location Address30 LANCASTER STREET, SUITE 400Boston, MA 02114-2517
Mailing Address526 Main St Ste 302Acton, MA 01720-3310 · (978) 371-7010 · Fax (978) 371-0522
Phone(617) 722-4100
Fax(617) 227-1134
Organization SubpartNo
Authorized OfficialSamuel D GoosOwner/managing Partner · (978) 371-7010
Enumeration DateJune 25, 2006
Last NPPES UpdateOctober 6, 20264 updates tracked since enumeration
NPPES CertifiedOctober 6, 2026
✔ NPI 1215963574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ 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 ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
Also ListedPathology · Anatomic Pathology & Clinical PathologyTaxonomy 207ZP0102X
30 LANCASTER STREET, Boston, MA 02114
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Secondary Practice Location 1

Location 125 Carleton St Bldg E23Cambridge, MA 02142-1323 · Phone (617) 258-9768 · Fax (877) 947-2327

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Boston Dermatology And Laser Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Boston Dermatology And Laser Center, LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

David Li, MD, MBA
Dermatology
NPI 1891355186
30 LANCASTER ST STE 400
Boston, MA 02114
(617) 722-4100
✔ PECOS✔ Accepts MedicareSame address
Julia Siegel, MD
Dermatology
NPI 1528599651
30 LANCASTER ST STE 400
Boston, MA 02114
(781) 454-8868
✔ PECOS✔ Accepts MedicareSame address
Robert Staszewski, M.D.
Dermatology
NPI 1891785168
30 LANCASTER STREET SUITE 400
Boston, MA 02114
(617) 722-4100
✔ PECOS✔ Accepts MedicareSame address

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 22D0976301

Boston Dermatology & Laser Center · Boston, MA
Expired · Oct 15, 2026
CLIA Number22D0976301
Laboratory TypePhysician Office
Certificate Effective DateOctober 16, 2024
Certificate Expiration DateOctober 15, 2026
Laboratory DirectorHelen A. Raynham
Laboratory Phone(617) 722-4100
Laboratory LocationBoston Dermatology & Laser Center30 Lancaster Street, Boston, MA 02114
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.

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 Boston Dermatology And Laser Center, LLC's NPI number?

The NPI number for Boston Dermatology And Laser Center, LLC is 1215963574. It was assigned to this organization in the NPPES registry on June 25, 2006.

Where is Boston Dermatology And Laser Center, LLC located?

Boston Dermatology And Laser Center, LLC is located at 30 Lancaster Street Suite 400, Boston, MA 02114. The listed phone number is (617) 722-4100.

What is Boston Dermatology And Laser Center, LLC's specialty?

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

Is Boston Dermatology And Laser Center, LLC enrolled in Medicare?

Yes. Boston Dermatology And Laser Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Boston Dermatology And Laser Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Dermatology, reassign their Medicare billing to Boston Dermatology And Laser Center, 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Boston Dermatology And Laser Center, LLC was last updated on October 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.