Organization Active NPI

Esse Dermatology

  • Dermatology Physician
  • Charlotte, NC
National Provider Identifier
1063286482
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ESSE DERMATOLOGY
Practice address
2550 Freedom Dr Ste B
Charlotte, NC 28208-3985
Phone
(415) 802-1310
NPI assigned
Nov 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
Dr. Ada Tolutope Ogunsiakan, MDNPI 1255862058
Title
Ceo/Dermatologist
Phone
(415) 802-1310

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

2550 Freedom Dr Ste B
Charlotte, NC 28208-3985

Mailing address

4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010
Phone (415) 802-1310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240801001359 NC Part B Supplier - Clinic/Group Practice 4082151642 Receives reassigned benefits from 2 practitioners
Practice locations: Charlotte, NC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2306363Esse Dermatology2550 Freedom Drive, Unit B, Charlotte, NC 28208Certificate of waiverJun 16, 2028

National Provider Directory

National Provider Directory

Locations

2550 Freedom Dr
Ste B
Charlotte, NC 28208
Phone (678) 472-8178

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00395

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1063286482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 349",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276090010",
            "telephone_number": "415-802-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 FREEDOM DR STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282083985",
            "telephone_number": "415-802-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSE DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "OGUNSIAKAN",
        "authorized_official_first_name": "ADA",
        "authorized_official_middle_name": "TOLUTOPE",
        "authorized_official_title_or_position": "CEO/DERMATOLOGIST",
        "authorized_official_telephone_number": "415-802-1310",
        "authorized_official_name_prefix": "Dr.",
        "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": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.