JEREMY S BORDEAUX MD MPH NPI 1043242589

NPI Information

  • NPI: 1043242589
  • Provider Name: JEREMY S BORDEAUX, MD MPH
  • Classification: Dermatology - 207ND0101X
  • Specialization: MOHS-Micrographic Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 281 LINCOLN STREET
    UMASS DERMATOLOGY HAHNEMANN CAMPUS
    WORCESTER, MA
    ZIP 01605
  • Phone: (508) 334-5971

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NPI Details

Jeremy S Bordeaux, MD MPH is a mohs-micrographic surgery dermatology in Worcester, MA with 28 years of experience. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. Jeremy S Bordeaux, MD MPH NPI is 1043242589. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: DUKE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1998

The provider's business location address is:

281 LINCOLN STREET
UMASS DERMATOLOGY HAHNEMANN CAMPUS
WORCESTER, MA
ZIP 01605
Phone: (508) 334-5971

The NPI 1043242589 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks (HCPCS:17311)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks (HCPCS:17312)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm (HCPCS:13132)
  • Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks (HCPCS:17313)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm (HCPCS:13121)
  • Special stained specimen slides to examine tissue, initial procedure (HCPCS:88342)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm (HCPCS:13152)
  • Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS:12032)
  • Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less (HCPCS:13122)
  • Complicated repair of wound of trunk, 2.6-7.5 cm (HCPCS:13101)
  • Removal and microscopic exam of growth of trunk, arms, or legs, each additional stage, 1-5 tissue blocks (HCPCS:17314)
  • Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11603)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less (HCPCS:13133)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 7/7/2006 and was last updated on 12/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207N00000XDermatology35-089926OHIONo
2207ND0101XDermatologyMOHS-Micrographic Surgery228008MASSACHUSETTSNo
3207NS0135XDermatologyProcedural Dermatology35-089926OHIONo
4207ND0101XDermatologyMOHS-Micrographic Surgery35-089926OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00406576OTHEROHIORAILROAD MEDICARE
2000000221131OTHEROHIOUNISON
3414951OTHEROHIOWELLCARE
45569102OTHEROHIOAETNA
5750496OTHEROHIOBUCKEYE
62771522MEDICAIDOHIO
7000000524092OTHEROHIOANTHEM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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