DERMASAP PLLC
NPI 1477937480
Dermatology in Quincy, MA

Active since July 20, 2015CLIA 22D0686370 · Certificate of Compliance
500 CONGRESS ST, B1, QUINCY, MA 02169(617) 472-6764 Get Directions Write a Review

NPPES record last updated: December 27, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dermasap Pllc NPPES

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

DERMASAP PLLC (NPI 1477937480) is a healthcare organization registered as a dermatology in Quincy, Massachusetts and active in the NPI registry since July 2015. The organization holds a CLIA Certificate of Compliance certificate valid through December 10, 2026 and lists Staci Goodwin, Om, as its authorized official.

NPPES Registry Identity

NPI1477937480
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMASAP PLLC
Location Address500 CONGRESS ST, B1Quincy, MA 02169-0908
Mailing Address500 Congress St, B1Quincy, MA 02169-0908 · (617) 472-6764
Organization SubpartNo
Authorized OfficialStaci GoodwinOm · (617) 472-6764
Enumeration DateJuly 20, 2015
Last NPPES UpdateDecember 27, 2016
NPI 1477937480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in MA · 49076
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.
500 CONGRESS ST, Quincy, MA 02169

Other Identifiers 4

Medicare PIN043214763MA
Medicare OSCAR/certification043214763
Medicare UPIN043214763MA
Medicaid043214763MA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 22D0686370

Dermasap/Id Of Quincy · Quincy, MA
Active · expires Dec 10, 2026
CLIA Number22D0686370
Laboratory TypePhysician Office
Certificate Effective DateDecember 11, 2024
Certificate Expiration DateDecember 10, 2026
Laboratory DirectorChristina M. Correnti
Laboratory Phone(617) 472-6764
Laboratory LocationDermasap/Id Of Quincy104 Quarry Street, Suite 2, Quincy, MA 02169
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.

Other Providers at the Same Location NPPES 20

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

Pediatrics
500 CONGRESS ST, SUITE 1F
QUINCY, MA 02169
Dentist (General Practice)
500 CONGRESS ST, SUITE#3E
QUINCY, MA 02169
Dentist (General Practice)
500 CONGRESS ST, SUITE 2D
QUINCY, MA 02169
Audiologist
500 CONGRESS ST
QUINCY, MA 02169
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
500 CONGRESS ST, SUITE 1H
QUINCY, MA 02169
Internal Medicine
500 CONGRESS ST, 3RD FLOOR
QUINCY, MA 02169
Internal Medicine (Endocrinology, Diabetes & Metabolism)
500 CONGRESS ST, 3RD FLOOR
QUINCY, MA 02169
Surgery (Plastic and Reconstructive Surgery)
500 CONGRESS ST, SUITE B1
QUINCY, MA 02169

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 Dermasap PLLC's NPI number?

The NPI number for Dermasap PLLC is 1477937480. It was assigned to this organization in the NPPES registry on July 20, 2015.

Where is Dermasap PLLC located?

Dermasap PLLC is located at 500 Congress St B1, Quincy, MA 02169. The listed phone number is (617) 472-6764.

What is Dermasap PLLC's specialty?

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

Does Dermasap PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 22D0686370) is associated with this NPI, valid through December 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dermasap PLLC was last updated on December 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.