Individual provider Active NPI

Graeme M Lipper, MD

  • Dermatology Physician
  • Danbury, CT
National Provider Identifier
1154371904
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
040494 Issued in CT
Practice address
25 Tamarack Ave
Advanced Derm Care PC
Danbury, CT 06811-4829
Phone
(203) 797-8990
Fax
(203) 748-7861
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 040494 CT Primary

Addresses

Primary practice location

25 Tamarack Ave
Advanced Derm Care PC
Danbury, CT 06811-4829

Mailing address

25 Tamarack Ave
Advanced Derm Care PC
Danbury, CT 06811
Phone (203) 797-8990

Other identifiers 1

IdentifierTypeStateIssuer
001404946MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927001359 CT Practitioner - Dermatology 4082730049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermcare PCGroup PAC ID 8628043924, 10 clinicians

Practice addresses (Care Compare)

25 Tamarack Ave
Danbury, CT 06811-4829
Phone (203) 797-8990

Hospital & facility affiliations

  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

Merit-based Incentive Payment System (MIPS)

Final score
95.15 of 100Reported as group
Quality
87.88
Improvement activities
40
Cost
100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision34
Removal of skin lesions1431
Skin biopsy433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
040494CTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermcare PC Dermatology CurrentSince Jul 1, 2002 Accepting new patients

Locations

25 Tamarack Ave
Danbury, CT 06811
Phone (203) 797-8990

760 Main St S
Ste C-2
Southbury, CT 06488
Phone (203) 797-8990

Interoperability endpoints

  • Direct secure messaging: glipper@direct.wtbyhosp.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1154371904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 TAMARACK AVE",
            "address_2": "ADVANCED DERM CARE PC",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "06811",
            "telephone_number": "203-797-8990",
            "fax_number": "203-748-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 TAMARACK AVE",
            "address_2": "ADVANCED DERM CARE PC",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068114829",
            "telephone_number": "203-797-8990",
            "fax_number": "203-748-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPER",
        "first_name": "GRAEME",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "040494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001404946",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.