INTEGRATED DERMATOLOGY OF WORCESTER II LLC
NPI 1659046340
Dermatology in Worcester, MA

Active since August 13, 2021CLIA 22D2323613 · Waiver
255 PARK AVE STE 509, WORCESTER, MA 01609(508) 890-5500(508) 890-5505 Get Directions Write a Review

NPPES record last updated: October 8, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 8, 2025, Aug 13, 2021 (2 updates tracked since 2021).

About Integrated Dermatology Of Worcester Ii Llc NPPES

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

INTEGRATED DERMATOLOGY OF WORCESTER II LLC (NPI 1659046340) is a healthcare organization registered as a dermatology in Worcester, Massachusetts and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through May 8, 2027 and lists Robert Benson, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1659046340
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF WORCESTER II LLC
Location Address255 PARK AVE STE 509Worcester, MA 01609-1989
Mailing Address255 Park Ave Ste 509Worcester, MA 01609-1989 · (508) 890-5500 · Fax (508) 890-5505
Fax(508) 890-5505
Organization SubpartNo
Authorized OfficialRobert BensonAuthorized Official · (561) 223-8081
Enumeration DateAugust 13, 2021
Last NPPES UpdateOctober 8, 20252 updates tracked since enumeration
NPPES CertifiedOctober 8, 2025
✔ NPI 1659046340 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.
255 PARK AVE STE 509, Worcester, MA 01609

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)

Integrated Dermatology Of Worcester Ii 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 Integrated Dermatology Of Worcester II LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Dermatology
NPI 1699354100
255 PARK AVE STE 509
Worcester, MA 01609
(508) 890-5500
✔ PECOSSame address
Nurse Practitioner
NPI 1801048921
255 PARK AVE STE 509
Worcester, MA 01609
(508) 890-5500
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1730619925
1101 BEACON ST # 1E
Brookline, MA 02446
(617) 731-2390
✔ PECOS✔ Accepts Medicare37 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 Waiver 22D2323613

Integrated Dermatology Of Worcester · Worcester, MA
Active · expires May 8, 2027
CLIA Number22D2323613
Laboratory TypePhysician Office
Certificate Effective DateMay 9, 2025
Certificate Expiration DateMay 8, 2027
Laboratory DirectorNeil Houston
Laboratory Phone(508) 356-7084
Laboratory LocationIntegrated Dermatology Of Worcester255 Park Ave Suite 509, Worcester, MA 01609
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Integrated Dermatology Of Worcester II LLC's NPI number?

The NPI number for Integrated Dermatology Of Worcester II LLC is 1659046340. It was assigned to this organization in the NPPES registry on August 13, 2021.

Where is Integrated Dermatology Of Worcester II LLC located?

Integrated Dermatology Of Worcester II LLC is located at 255 Park Ave Ste 509, Worcester, MA 01609. The listed phone number is (508) 890-5500.

What is Integrated Dermatology Of Worcester II LLC's specialty?

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

Is Integrated Dermatology Of Worcester II LLC enrolled in Medicare?

Yes. Integrated Dermatology Of Worcester II LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Integrated Dermatology Of Worcester II LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Integrated Dermatology Of Worcester II LLC, in Dermatology and Nurse Practitioner. 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, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Integrated Dermatology Of Worcester II LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2323613) is associated with this NPI, valid through May 8, 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 Integrated Dermatology Of Worcester II LLC was last updated on October 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.