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DERMWELLESLEY LLC
NPI 1811478092
Dermatology in Wellesley, MA

Active since August 24, 2018CLIA 22D2158894 · Certificate of Compliance
20 WILLIAM ST, WELLESLEY, MA 02481(781) 591-4234(781) 369-9737 Get Directions Write a Review

NPPES record last updated: January 3, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 3, 2019, Aug 24, 2018 (2 updates tracked since 2018).

About Dermwellesley Llc NPPES

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

DERMWELLESLEY LLC (NPI 1811478092) is a healthcare organization registered as a dermatology in Wellesley, Massachusetts and active in the NPI registry since August 2018. The organization holds a CLIA Certificate of Compliance certificate valid through May 16, 2027 and lists Emily Wise, Owner, as its authorized official.

NPPES Registry Identity

NPI1811478092
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMWELLESLEY LLC
Location Address20 WILLIAM STWellesley, MA 02481-4103
Mailing Address20 William StWellesley, MA 02481-4103 · (781) 591-4234 · Fax (857) 317-2811
Phone(781) 591-4234
Fax(781) 369-9737
Organization SubpartNo
Authorized OfficialEmily WiseOwner · (857) 317-2057
Enumeration DateAugust 24, 2018
Last NPPES UpdateJanuary 3, 20192 updates tracked since enumeration
✔ NPI 1811478092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in MA · 254256
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.
20 WILLIAM ST, Wellesley, MA 02481
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Other Identifiers 1

Other1487882270Individual Npi

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)

Dermwellesley Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Dermwellesley LLC, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 8 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 4

Dermatology6
Nurse Practitioner2
Micrographic Dermatologic Surgery (MDS)1
Ophthalmology1

Clinicians, nearest first (10)

Caren Droesch, M.D.
Dermatology
NPI 1396193777
20 WILLIAM ST STE G15
Wellesley, MA 02481
(781) 591-4234
✔ PECOS✔ Accepts MedicareSame address
Jacqueline Goldminz, MD
Dermatology
NPI 1215466719
20 WILLIAM ST STE G15
Wellesley, MA 02481
(781) 591-4234
✔ PECOS✔ Accepts MedicareSame address
Barbara Stjohn, N.P.
Nurse Practitioner
NPI 1275886285
20 WILLIAM ST STE G15
Wellesley, MA 02481
(781) 591-4234
✔ PECOS✔ Accepts MedicareSame address
Emily Wise, MD
Dermatology
NPI 1487882270
20 WILLIAM ST STE G15
Wellesley, MA 02481
(781) 591-4234
✔ PECOS✔ Accepts MedicareSame address
Sara Berg, MD
Dermatology
NPI 1750776712
20 WILLIAM ST STE G15
Wellesley, MA 02481
(781) 591-4234
✔ PECOS✔ Accepts MedicareSame address
Lindsay Mccormack, MD
Dermatology
NPI 1831765148
20 WILLIAM ST STE G15
Wellesley, MA 02481
(781) 591-4234
✔ PECOSSame address
Julia Marvel, NP
Nurse Practitioner
NPI 1003572413
37 HAMILTON RD
Waltham, MA 02453
(781) 801-6385
✔ PECOS✔ Accepts Medicare4.0 mi
Alison Callahan, MD
Ophthalmology
NPI 1992016059
800 WASHINGTON ST
Boston, MA 02111
(617) 636-5000
✔ PECOS✔ Accepts Medicare8.8 mi
Tiffany Sun, M.D. PH.D.
Micrographic Dermatologic Surgery (MDS)
NPI 1245620921
67 S BEDFORD ST
Burlington, MA 01803
(781) 744-5100
✔ PECOS✔ Accepts Medicare13 mi
Mariko Yasuda, M.D.
Dermatology
NPI 1073741385
281 LINCOLN ST DERMATOLOGY RESIDENCY
Worcester, MA 01605
(508) 334-5971
✔ PECOS✔ Accepts Medicare29 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 Compliance 22D2158894

Dermwellesley, LLC · Wellesley, MA
Active · expires May 16, 2027
CLIA Number22D2158894
Laboratory TypePhysician Office
Certificate Effective DateMay 17, 2025
Certificate Expiration DateMay 16, 2027
Laboratory DirectorTiffany Sun
Laboratory Phone(781) 591-4234
Laboratory LocationDermwellesley, LLC20 William St G15, Wellesley, MA 02481
CLIA data matches this NPI record on: Address 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.

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 Dermwellesley LLC's NPI number?

The NPI number for Dermwellesley LLC is 1811478092. It was assigned to this organization in the NPPES registry on August 24, 2018.

Where is Dermwellesley LLC located?

Dermwellesley LLC is located at 20 William St, Wellesley, MA 02481. The listed phone number is (781) 591-4234.

What is Dermwellesley LLC's specialty?

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

Is Dermwellesley LLC enrolled in Medicare?

Yes. Dermwellesley LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermwellesley LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 4 Medicare specialties reassign their Medicare billing to Dermwellesley 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 (6), Nurse Practitioner (2) and Micrographic Dermatologic Surgery (MDS) (1). Of these, 6 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dermwellesley LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 22D2158894) is associated with this NPI, valid through May 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dermwellesley LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Dermwellesley 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 Dermwellesley LLC was last updated on January 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.