Organization Active NPI

On Site Dermatology of Michigan, PLLC

  • Dermatology Physician
  • Novi, MI
National Provider Identifier
1114809811
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ON SITE DERMATOLOGY OF MICHIGAN, PLLC
Practice address
41000 W 13 Mile Rd
Novi, MI 48377-2800
Phone
(877) 345-5300
NPI assigned
Jul 23, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Animesh Sinha, MDNPI 1285733014
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 Physician 207N00000X NU Primary

Addresses

Primary practice location

41000 W 13 Mile Rd
Novi, MI 48377-2800

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 MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250915000111 MI Part B Supplier - Clinic/Group Practice 2062915085 Receives reassigned benefits from 3 practitioners
Practice locations: Westland, MI; Sterling Heights, MI; Shelby Township, MI; Saint Clair Shores, MI; Roseville, MI; Novi, MI; East Lansing, MI; Chesterfield, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1114809811",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41000 W 13 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772800",
            "telephone_number": "877-345-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON SITE DERMATOLOGY OF MICHIGAN, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "SINHA",
        "authorized_official_first_name": "ANIMESH",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "561-314-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.