OrganizationActive
Id of Massachusetts LLC
NPI 1477229326 · Dermatology Physician · Quincy, MA
Id of Massachusetts LLC is a Dermatology Physician organization in Quincy, MA (NPI 1477229326).
Provider details
- NPI number
- 1477229326
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jennifer Jackson, Authorized Official(561) 223-8081
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(66/100 index)
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
104 Quarry St Ste 2
Quincy, MA 02169-4174
Phone: (617) 472-6764
Fax: (617) 770-9933
Street-level locationGet directions
Mailing address
4700 Exchange Ct Ste 110
Boca Raton, FL 33431-4450
Additional practice locations (1)
- 40 Industrial Park Rd Ste 202Plymouth, MA 02360-4884Phone: (617) 472-6764Fax: (617) 770-9933
Registry dates
- Enumerated
- 2021-08-20
- Last updated
- 2026-01-27
- Certified
- 2026-01-27
Frequently asked questions
- What is Id of Massachusetts LLC's NPI number?
- Id of Massachusetts LLC's National Provider Identifier (NPI) is 1477229326, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Id of Massachusetts LLC?
- Id of Massachusetts LLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Id of Massachusetts LLC located?
- Id of Massachusetts LLC's practice location on file with NPPES is 104 Quarry St Ste 2, Quincy, MA 02169-4174.
- What is Id of Massachusetts LLC's phone number?
- The practice phone number listed in the NPPES registry for Id of Massachusetts LLC is (617) 472-6764.
- Who is the authorized official for Id of Massachusetts LLC?
- The authorized official listed on Id of Massachusetts LLC's NPPES record is Jennifer Jackson, Authorized Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Id of Massachusetts LLC's NPI active?
- Yes — Id of Massachusetts LLC's NPI (1477229326) 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.