NPIMap

Organization Active NPI

Clearsolutions Dermatology Group

  • Dermatology Physician
  • Lewes, DE
National Provider Identifier
1013626753
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CLEARSOLUTIONS DERMATOLOGY GROUP
Practice address
17644 Coastal Hwy
Lewes, DE 19958-6257
Phone
(877) 425-7756
NPI assigned
Nov 22, 2022
Last updated
Apr 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jason StabackNPI 1750331948
Title
Owner
Phone
(877) 425-7756

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

17644 Coastal Hwy
Lewes, DE 19958-6257

Mailing address

17644 Coastal Hwy #6
Lewes, DE 19958
Phone (877) 425-7756

Other practice location 1

1 Centurian Dr
Newark, DE 19713-2137
Phone (877) 425-7756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230315001346 DE Part B Supplier - Clinic/Group Practice 4981078953 Receives reassigned benefits from 6 practitioners
Practice locations: Lewes, DE; Middletown, DE

National Provider Directory

National Provider Directory

Locations

1537 Savannah Rd
Ste A
Lewes, DE 19958
Phone (302) 412-0135

17644 Coastal Hwy
Lewes, DE 19958
Phone (302) 272-1206

17644 Coastal Hwy
#G
Lewes, DE 19958
Phone (877) 425-7756

17644 Coastal Hwy
Ste 6
Lewes, DE 19958
Phone (877) 425-7756

34434 King Street Row
Ste 4
Lewes, DE 19958
Phone (302) 360-0142

601 Tower Ln
Middletown, DE 19709
Phone (877) 425-7756

1 Centurian Dr
Ste 301
Newark, DE 19713
Phone (302) 994-8492

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1013626753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17644 COASTAL HWY #6",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "19958",
            "telephone_number": "877-425-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17644 COASTAL HWY",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199586257",
            "telephone_number": "877-425-7756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Centurian Dr",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197132137",
            "country_code": "US",
            "telephone_number": "877-425-7756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLEARSOLUTIONS DERMATOLOGY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "STABACK",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-425-7756"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewes, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.