Dermatology & Cosmetic Center of Bloomfield Hills PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY & COSMETIC CENTER OF BLOOMFIELD HILLS PLLC

Practice address

39533 Woodward Ave Ste 155
Bloomfield Hills, MI 48304-5188

Phone

(833) 322-3376

NPI assigned

Jan 5, 2026

Organization subpart

No

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

Authorized official

Name

Wasim Nasir, MDNPI 1205222171

Title

Owner

Phone

(248) 703-8173

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 9

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

• Wasim Nasir, MD

  • Dermatology Physician
  • Flint, MI
  • NPI 1205222171
  Medicare reassignment NPD Authorized official
• Veronica Ercolani, RN

  • Family Nurse Practitioner
  • Shelby TWP, MI
  • NPI 1700475191
  Medicare reassignment NPD
• Halimeh Farhat, PA-C

  • Physician Assistant
  • Flint, MI
  • NPI 1750094223
  Medicare reassignment NPD
• Katrina Daisy Mansour

  • Physician Assistant
  • Flint, MI
  • NPI 1396609715
  Medicare reassignment NPD
• Lesli Uvario-Romo, PA-C

  • Physician Assistant
  • Flint, MI
  • NPI 1215729488
  Medicare reassignment NPD
• Deanna Marie Wagner, M.D.

  • Dermatology Physician
  • Bloomfield Hills, MI
  • NPI 1104141654
  Medicare reassignment NPD
• Tyler Drake Menge, MD

  • Dermatopathology (Pathology) Physician
  • Roseville, MN
  • NPI 1922461235

  Dermatology, MI

  Medicare reassignment NPD
• Henna S. Shah, APN

  • Family Nurse Practitioner
  • West Long Branch, NJ
  • NPI 1629517925

  MI

  Medicare reassignment NPD
• Kaitlyn Mackenzie Shaw

  • Physician Assistant
  • Bloomfield Hills, MI
  • NPI 1952141863
  NPD (past)

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

{
    "created_epoch": "1767571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1073479945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39533 WOODWARD AVE STE 155",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39533 WOODWARD AVE STE 155",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045188",
            "telephone_number": "833-322-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & COSMETIC CENTER OF BLOOMFIELD HILLS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-04",
        "status": "A",
        "authorized_official_last_name": "NASIR",
        "authorized_official_first_name": "WASIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-703-8173",
        "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": []
}

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• Surbhi Desai, DMD
• Jennifer Deschryver, PSY.D.
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• Sheila Kanti Dhandha, M.D.

• Dermatology Physician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.