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SOUTH SHORE SKIN CENTER, LLC
NPI 1790763159
Specialist in Plymouth, MA

Active since January 05, 2006
1 SCOBEE CIR, UNIT 3, PLYMOUTH, MA 02360(508) 747-0711(508) 746-9265 Get Directions Write a Review

NPPES record last updated: June 29, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About South Shore Skin Center, Llc NPPES

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

SOUTH SHORE SKIN CENTER, LLC (NPI 1790763159) is a healthcare organization registered as a specialist in Plymouth, Massachusetts and active in the NPI registry since January 2006. The organization lists Richard F Eisen, Manager, as its authorized official.

NPPES Registry Identity

NPI1790763159
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTH SHORE SKIN CENTER, LLC
Location Address1 SCOBEE CIR, UNIT 3Plymouth, MA 02360-4887
Mailing Address1 Scobee Cir, Unit 3Plymouth, MA 02360-4887 · (508) 747-0711 · Fax (508) 746-9265
Phone(508) 747-0711
Fax(508) 746-9265
Organization SubpartNo
Authorized OfficialRichard F EisenManager · (508) 747-0711
Enumeration DateJanuary 5, 2006
Last NPPES UpdateJune 29, 2015
✔ NPI 1790763159 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.
1 SCOBEE CIR, Plymouth, MA 02360
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Other Identifiers 3

Other685603MA · Tufts Health Plan
Medicare PINM20779MA
OtherM17452MA · Blue Cross And Blue Shiel

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)

South Shore Skin Center, 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 Shore Skin Center, LLC, which bills Medicare for the services they deliver. Of these, 9 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Dermatology8
Nurse Practitioner2
Pathology1

Clinicians, nearest first (11)

Navid Bouzari, M.D.
Dermatology
NPI 1417168535
1 SCOBEE CIR STE 3 SOUTH SHORE SKIN CENTER
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.1 mi
Nicole Giardino, APRN, FNP-C
Nurse Practitioner
NPI 1376961292
1 SCOBEE CIR
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.1 mi
Ricardo Pollitt, M.D., PH.D.
Dermatology
NPI 1578889911
1 SCOBEE CIR
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.1 mi
Ramzi Saad, MD
Dermatology
NPI 1508862467
1 SCOBEE CIR UNIT 3
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.1 mi
Tivon Sidorsky, MD, MBA, FAAD
Dermatology
NPI 1285952846
1 SCOBEE CIR STE 3
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.1 mi
Lauren Strazzula, M.D.
Dermatology
NPI 1598178923
1 SCOBEE CIR STE 3
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.1 mi
Brittany Walsh, FNP
Nurse Practitioner
NPI 1528596715
1 SCOBEE CIR
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.1 mi
Katherine Ayers, M.D.
Dermatology
NPI 1104923069
1 SCOBEE CIR UNIT 3
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.1 mi
Lara Butler, M.D.
Dermatology
NPI 1619295847
ONE SCOBEE CIRCLE, UNIT 3 SOUTH SHORE SKIN CENTER
Plymouth, MA 02360
(508) 747-0711
✔ PECOS✔ Accepts Medicare0.2 mi
Kelly O'connor, MD
Dermatology
NPI 1659875540
75 WASHINGTON ST STE 200
Norwell, MA 02061
(781) 878-6495
✔ PECOS✔ Accepts Medicare18 mi
Alireza Sepehr, M.D.
Pathology
NPI 1336171867
35 BROOKFIELD RD
Dover, MA 02030
(508) 785-1076
✔ PECOS✔ Accepts Medicare34 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 South Shore Skin Center, LLC's NPI number?

The NPI number for South Shore Skin Center, LLC is 1790763159. It was assigned to this organization in the NPPES registry on January 5, 2006.

Where is South Shore Skin Center, LLC located?

South Shore Skin Center, LLC is located at 1 Scobee Cir Unit 3, Plymouth, MA 02360. The listed phone number is (508) 747-0711.

What is South Shore Skin Center, LLC's specialty?

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

Is South Shore Skin Center, LLC enrolled in Medicare?

Yes. South Shore Skin Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through South Shore Skin Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 3 Medicare specialties reassign their Medicare billing to South Shore Skin 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. The largest specialties are Dermatology (8), Nurse Practitioner (2) and Pathology (1). Of these, 9 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does South Shore Skin Center, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list South Shore Skin Center, LLC 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 South Shore Skin Center, LLC was last updated on June 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.