Windsor Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

WINDSOR DERMATOLOGY PC

Practice address

59 One Mile Road
Suite G
East Windsor, NJ 08520

Phone

(609) 443-4500

Fax

(609) 443-4808

NPI assigned

Aug 25, 2006

Last updated

Aug 1, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jerry Bagel, MDNPI 1992772156

Title

President

Phone

(609) 443-4500

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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.

• Jerry Bagel, MD

  • Dermatology Physician
  • East Windsor, NJ
  • NPI 1992772156
  Authorized official Same address or phone
• John Frederick Chambliss, MS PAC

  • Physician Assistant
  • East Windsor, NJ
  • NPI 1184690406
  NPD (past)
• Mindy Slater-Patti, PA

  • Physician Assistant
  • Toms River, NJ
  • NPI 1508832213
  NPD (past)
• Amy B Matorin, PA-C

  • Physician Assistant
  • Yardley, PA
  • NPI 1811195720
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1053429720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ONE MILE ROAD",
            "address_2": "SUITE G",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "08520",
            "telephone_number": "609-443-4500",
            "fax_number": "609-443-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 ONE MILE ROAD",
            "address_2": "SUITE G",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "08520",
            "telephone_number": "609-443-4500",
            "fax_number": "609-443-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDSOR DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "BAGEL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-443-4500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khyia S Washington
• Weight and Wellness Clinic LLC
• Willow and Well Therapy
• Windsor Anesthesia LLC
• Windsor Dental Associates
• Windsor Gastroenterology Associates (Windsor Center for Digestive Health)
• Windsor Internal Medicine and Geriatria
• Windsor Medical Center, PA (Windsor Medical Center Inc)
• Windsor Regional Medical Associates, LLC
• Windsor Supportive Services

• Dermatology Physician in East Windsor, NJ
• Providers in East Windsor, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.