Organization Active NPI

Alliance Dermatology Physicians, P.C.

  • Dermatology Physician
  • Newtown, PA
National Provider Identifier
1093368185
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ALLIANCE DERMATOLOGY PHYSICIANS, P.C.
Practice address
11 Friends LN Ste 115
Newtown, PA 18940-1885
Phone
(609) 799-1600
Fax
(609) 799-7617
NPI assigned
Jul 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Lusia S YiNPI 1740424035
Title
Partner/Owner
Phone
(609) 799-1600

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

11 Friends LN Ste 115
Newtown, PA 18940-1885

Mailing address

11 Friends LN Ste 115
Newtown, PA 18940-1885
Phone (609) 799-1600

Other practice location 1

3311 Brunswick Pike
Lawrenceville, NJ 08648-2411
Phone (609) 799-1600

Other practice location 2

29 Emmons Dr Ste F20
Princeton, NJ 08540-5978
Phone (609) 799-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191219001301 NJ Part B Supplier - Clinic/Group Practice 9133553449 Receives reassigned benefits from 4 practitioners
Practice locations: Princeton, NJ
O20191226000023 PA Part B Supplier - Clinic/Group Practice 9133553449 Receives reassigned benefits from 5 practitioners
Practice locations: Warminster, PA; Newtown, PA

National Provider Directory

National Provider Directory
Tax ID family
Alliance Dermatology Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3311 US Highway 1
Lawrenceville, NJ 08648
Phone (609) 716-7030

29 Emmons Dr
Ste F20
Princeton, NJ 08540
Phone (609) 799-1600

11 Friends Ln
Ste 115
Newtown, PA 18940
Phone (609) 799-1600

Practitioners & affiliated clinicians

Practitioners 5

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": "1563408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1093368185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FRIENDS LN STE 115",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401885",
            "telephone_number": "609-799-1600",
            "fax_number": "609-799-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FRIENDS LN STE 115",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189401885",
            "telephone_number": "609-799-1600",
            "fax_number": "609-799-7617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3311 Brunswick Pike",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "NJ",
            "postal_code": "086482411",
            "country_code": "US",
            "telephone_number": "609-799-1600",
            "fax_number": "609-799-7617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 Emmons Dr Ste F20",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "NJ",
            "postal_code": "085405978",
            "country_code": "US",
            "telephone_number": "609-799-1600",
            "fax_number": "267-358-5166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLIANCE DERMATOLOGY PHYSICIANS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-18",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "YI",
        "authorized_official_first_name": "LUSIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "609-799-1600"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.