Dermatology Centre of Northeast Ohio, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

35059099 Issued in OH

Legal business name

DERMATOLOGY CENTRE OF NORTHEAST OHIO, LLC

Practice address

960 Windham CT
Suite 2
Youngstown, OH 44512

Phone

(330) 758-8866

Fax

(330) 758-4051

NPI assigned

Jan 19, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Terri L Stilson

Title

Practice Manager

Phone

(330) 758-8866

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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 1

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

• Anthony Lawrence Mehle, M.D.

  • Dermatology Physician
  • Youngstown, OH
  • NPI 1609870567
  Medicare reassignment NPD

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063565513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 WINDHAM CT",
            "address_2": "SUITE 2",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-758-8866",
            "fax_number": "330-758-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 WINDHAM CT",
            "address_2": "SUITE 2",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-758-8866",
            "fax_number": "330-758-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CENTRE OF NORTHEAST OHIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STILSON",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "330-758-8866",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35059099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0784594",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Joseph Depaola, DDS
• Michael Phillip Deperro Jr., DDS
• Tony Thomas Deramo, MD
• Deborah Lynne Derflinger, RN
• Dermatology Associates of Youngstown Inc
• Matthew H Dermotta
• Christopher Derr
• Kasey Elizabeth Desalvo, PA-C
• Ester Siloe Deschenes, MD
• Alexis Monique Deslandes

• Specialist in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.