Legacy Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P2228 Issued in TX

Legal business name

LEGACY DERMATOLOGY, PLLC

Practice address

1360 Deer Lake Dr
Frisco, TX 75034-1731

Phone

(214) 799-6367

NPI assigned

Feb 18, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Warner Dharamsi, M.D.NPI 1255507794

Title

Owner

Phone

(972) 469-2626

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 8

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

• Jennifer Warner Dharamsi, M.D.

  • Dermatology Physician
  • Frisco, TX
  • NPI 1255507794
  Medicare reassignment Care Compare group Authorized official
• Max Frank Adler, MD

  • Dermatology Physician
  • Dallas, TX
  • NPI 1801835434
  Medicare reassignment Care Compare group NPD
• Jonathan Nathan, M.D.

  • Plastic Surgery Physician
  • Dallas, TX
  • NPI 1134449374
  Medicare reassignment Care Compare group NPD
• Denisa Kavikova Russell, P.A.

  • Medical Physician Assistant
  • Prosper, TX
  • NPI 1750628798
  Medicare reassignment Care Compare group NPD
• Melissa A Prasatik, PA-C

  • Physician Assistant
  • Kirkland, WA
  • NPI 1467670794

  TX

  Medicare reassignment Care Compare group NPD
• Bradley Ray Armstrong, PA-C

  • Physician Assistant
  • Denton, TX
  • NPI 1568545663
  Medicare reassignment Care Compare group
• Sarah Sadiq Bhatti, PA

  • Medical Physician Assistant
  • Allen, TX
  • NPI 1922483791
  Medicare reassignment Care Compare group
• Patrice M Simon, PA-C

  • Physician Assistant
  • Frisco, TX
  • NPI 1427326198
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1134588148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 LEGACY DR",
            "address_2": "SUITE 110",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75034",
            "telephone_number": "972-469-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 DEER LAKE DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750341731",
            "telephone_number": "214-799-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "DHARAMSI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "WARNER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-469-2626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P2228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yosuk Joseph Lee, D.M.D
• Shelby Alyse Leffingwell, PT, DPT
• Alyson Leftin, LCSW
• Legacy Dental Associates, P.C.
• Legacy Dental Associates, P.C.
• Legacy Foot and Ankle Specialists
• Legacy Internal Medicine, PLLC
• Legacy Physicians Group
• Legacy Physicians Group Florida LLC
• Legacy Physicians Group, LLC

• Dermatology Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.