NPIMap

Organization Active NPI

On Site Dermatology of Washington PLLC

  • Dermatology Physician
  • Seattle, WA
National Provider Identifier
1083135693
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ON SITE DERMATOLOGY OF WASHINGTON PLLC
Practice address
600 Stewart St Ste 400
Seattle, WA 98101-1217
Phone
(877) 345-5300
Fax
(561) 989-3665
NPI assigned
Jul 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Authorized official

Name
Adam Plotkin, MDNPI 1306896105
Title
Authorized Official
Phone
(561) 314-2000

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

600 Stewart St Ste 400
Seattle, WA 98101-1217

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 314-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171012001507 WA Part B Supplier - Clinic/Group Practice 8426323783 Receives reassigned benefits from 3 practitioners

National Provider Directory

National Provider Directory

Locations

23620 Marine View Dr S
Des Moines, WA 98198
Phone (206) 824-4000

524 75th St SE
Everett, WA 98203
Phone (425) 348-8800

2959 76th Ave SE
Mercer Island, WA 98040
Phone (206) 232-6565

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1083135693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-314-2000",
            "fax_number": "561-431-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 STEWART ST STE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011217",
            "telephone_number": "877-345-5300",
            "fax_number": "561-989-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON SITE DERMATOLOGY OF WASHINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "PLOTKIN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "561-314-2000",
        "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 Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.