Center of Dermatology, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

NE13516 Issued in NE

Legal business name

CENTER OF DERMATOLOGY, PC

Practice address

10110 Nicholas Street
Suite #103
Omaha, NE 68114-2185

Phone

(402) 398-9200

Fax

(402) 398-9400

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Herschel E Stoller, M.D.NPI 1356324495

Title

President

Phone

(402) 398-9200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

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 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Herschel E Stoller, M.D.

  • Dermatology Physician
  • Omaha, NE
  • NPI 1356324495
  Medicare reassignment NPD Authorized official
• Lillian Misle Stoller, M.D.

  • Psychiatry Physician
  • Omaha, NE
  • NPI 1215910369
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1053461137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 NICHOLAS STREET",
            "address_2": "SUITE #103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142185",
            "telephone_number": "402-398-9200",
            "fax_number": "402-398-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 NICHOLAS STREET",
            "address_2": "SUITE #103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142185",
            "telephone_number": "402-398-9200",
            "fax_number": "402-398-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER OF DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "STOLLER",
        "authorized_official_first_name": "HERSCHEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-398-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NE",
            "license": "NE13516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giselle Centeno-Rosales
• Emily M Centeno, RN, BSN, PMH-BC
• Center for Holistic Developement
• Center for Holistic Development
• Center for Hyperbaric Medicine LLC
• Center Street Dental, P.C.
• Centered Mindfulness
• Centered Minds LLC
• Centerpointe, Inc
• Centerpointe, Inc

• Dermatology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Dermatology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.