ON SITE DERMATOLOGY OF MASSACHUSETTS, LLC
NPI 1801217864
Dermatology in Harvard, MA

Active since December 18, 2013
39 E BARE HILL RD, HARVARD, MA 01451(877) 345-5300 Get Directions Write a Review

NPPES record last updated: April 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About On Site Dermatology Of Massachusetts, Llc NPPES

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

ON SITE DERMATOLOGY OF MASSACHUSETTS, LLC (NPI 1801217864) is a healthcare organization registered as a dermatology in Harvard, Massachusetts and active in the NPI registry since December 2013. The organization lists Jeffrey D. Queen, Owner, as its authorized official.

NPPES Registry Identity

NPI1801217864
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameON SITE DERMATOLOGY OF MASSACHUSETTS, LLC
Location Address39 E BARE HILL RDHarvard, MA 01451-1852
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000
Organization SubpartNo
Authorized OfficialJeffrey D. QueenOwner · (561) 314-2000
Enumeration DateDecember 18, 2013
Last NPPES UpdateApril 18, 2025
NPPES CertifiedApril 18, 2025
✔ NPI 1801217864 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.
39 E BARE HILL RD, Harvard, MA 01451

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)

On Site Dermatology Of Massachusetts, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to On Site Dermatology Of Massachusetts, LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (4)

Nurse Practitioner
NPI 1760159941
100 MARTIN LUTHER KING JR BLVD SUITE 200
Worcester, MA 01608
(774) 389-0887
✔ PECOS✔ Accepts Medicare18 mi
Nurse Practitioner
NPI 1922818129
255 PARK AVENUE SUITE 509
Worcester, MA 01609
(508) 890-5500
✔ PECOS✔ Accepts Medicare19 mi
Dermatology
NPI 1083681795
138 CONANT ST STE 1
Beverly, MA 01915
(978) 691-5690
✔ PECOS✔ Accepts Medicare35 mi
Dermatology
NPI 1326046830
610 FARM LANE
Doylestown, PA 18901
(215) 728-2754
✔ PECOS✔ Accepts Medicare237 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 On Site Dermatology Of Massachusetts, LLC's NPI number?

The NPI number for On Site Dermatology Of Massachusetts, LLC is 1801217864. It was assigned to this organization in the NPPES registry on December 18, 2013.

Where is On Site Dermatology Of Massachusetts, LLC located?

On Site Dermatology Of Massachusetts, LLC is located at 39 E Bare Hill Rd, Harvard, MA 01451. The listed phone number is (877) 345-5300.

What is On Site Dermatology Of Massachusetts, LLC's specialty?

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

Is On Site Dermatology Of Massachusetts, LLC enrolled in Medicare?

Yes. On Site Dermatology Of Massachusetts, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through On Site Dermatology Of Massachusetts, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to On Site Dermatology Of Massachusetts, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for On Site Dermatology Of Massachusetts, LLC was last updated on April 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.