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CANTON DERMATOLOGY CLINIC, INC
NPI 1295819290
Dermatology - Procedural Dermatology in Canton, MA

Active since October 25, 2006
95 WASHINGTON ST, CANTON, MA 02021(781) 821-2888(781) 821-8684 Get Directions Write a Review

NPPES record last updated: August 11, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Canton Dermatology Clinic, Inc NPPES

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

CANTON DERMATOLOGY CLINIC, INC (NPI 1295819290) is a healthcare organization registered as a procedural dermatology in Canton, Massachusetts and active in the NPI registry since October 2006. The organization lists Jafar Koupaie, President, as its authorized official.

NPPES Registry Identity

NPI1295819290
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameCANTON DERMATOLOGY CLINIC, INC
Location Address95 WASHINGTON STCanton, MA 02021-4006
Mailing Address95 Washington StCanton, MA 02021-4006 · (781) 821-2888 · Fax (781) 821-8684
Phone(781) 821-2888
Fax(781) 821-8684
Organization SubpartNo
Authorized OfficialJafar KoupaiePresident · (781) 821-2888
Enumeration DateOctober 25, 2006
Last NPPES UpdateAugust 11, 2014
✔ NPI 1295819290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
95 WASHINGTON ST, Canton, MA 02021
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Other Identifiers 1

Medicare PINM21105MA

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 ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Canton Dermatology Clinic, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Canton Dermatology Clinic, Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jafar Koupaie, MD
Dermatology
NPI 1508940644
9889 MAGNOLIA AVE STE A
Riverside, CA 92503
(951) 566-5634
✔ PECOS✔ Accepts Medicare2,557 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Canton Dermatology Clinic, Inc's NPI number?

The NPI number for Canton Dermatology Clinic, Inc is 1295819290. It was assigned to this organization in the NPPES registry on October 25, 2006.

Where is Canton Dermatology Clinic, Inc located?

Canton Dermatology Clinic, Inc is located at 95 Washington St, Canton, MA 02021. The listed phone number is (781) 821-2888.

What is Canton Dermatology Clinic, Inc's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Is Canton Dermatology Clinic, Inc enrolled in Medicare?

Yes. Canton Dermatology Clinic, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Canton Dermatology Clinic, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Canton Dermatology Clinic, Inc. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Canton Dermatology Clinic, Inc accept?

Health plans from Anthem Blue Cross and Blue Shield list Canton Dermatology Clinic, Inc 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 Canton Dermatology Clinic, Inc was last updated on August 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.