Id of Quincy LLC
NPI 1053088377 · Dermatology Physician · Quincy, MA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Id of Quincy LLC is a Dermatology Physician organization in Quincy, MA (NPI 1053088377).
Provider details
- NPI number
- 1053088377
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jennifer Haley, Authorized Group Official(561) 314-2000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 40 Industrial Park Rd Ste 202Plymouth, MA 02360-4884Phone: (617) 472-6764Fax: (617) 770-9933
Registry dates
- Enumerated
- 2021-08-25
- Last updated
- 2026-01-27
- Certified
- 2026-01-27
Frequently asked questions
- What is Id of Quincy LLC's NPI number?
- Id of Quincy LLC's National Provider Identifier (NPI) is 1053088377, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Id of Quincy LLC?
- Id of Quincy LLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Id of Quincy LLC located?
- Id of Quincy LLC's practice location on file with NPPES is 104 Quarry St Ste 2, Quincy, MA 02169-4174.
- What is Id of Quincy LLC's phone number?
- The practice phone number listed in the NPPES registry for Id of Quincy LLC is (617) 472-6764.
- Does Id of Quincy LLC accept Medicare?
- Id of Quincy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Id of Quincy LLC?
- The authorized official listed on Id of Quincy LLC's NPPES record is Jennifer Haley, Authorized Group Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Id of Quincy LLC's NPI active?
- Yes — Id of Quincy LLC's NPI (1053088377) is active in the NPPES registry as of the last update on 2026-01-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.