Id of Quincy LLC
NPI 1053088377ActiveOrganization· Dermatology· Quincy, MA
Dermatology in Quincy, Massachusetts, registered in NPPES in August 2021. The authorized official on file is Jennifer T. Haley, MD, Authorized Group Official. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1053088377 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 25, 2021 |
| Last updated in NPPES | Jan 27, 2026 |
| Certified by provider | Jan 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MA) |
|---|
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