Dermatology and Cosmetic Physicians, SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

53448-20 Issued in WI

Legal business name

DERMATOLOGY AND COSMETIC PHYSICIANS, SC

Practice address

2102 Continental Dr
West Bend, WI 53095-7898

Phone

(262) 558-4367

Fax

(920) 569-3369

NPI assigned

Jun 11, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Burt Steffes, MDNPI 1548449614

Title

Ceo

Phone

(262) 558-4367

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00078

Practitioners 1

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

• Burt James Steffes, MD

  • Dermatology Physician
  • Fond Du Lac, WI
  • NPI 1548449614
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1174016596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 CONTINENTAL DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957898",
            "telephone_number": "262-558-4367",
            "fax_number": "920-569-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 CONTINENTAL DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957898",
            "telephone_number": "262-558-4367",
            "fax_number": "920-569-3369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W5192 Rienzi Rd",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549359603",
            "country_code": "US",
            "telephone_number": "920-602-1741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERMATOLOGY AND COSMETIC PHYSICIANS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-11",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "STEFFES",
        "authorized_official_first_name": "BURT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-558-4367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WI",
            "license": "53448-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548449614",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Deering, APNP
• Teresa Delcore
• Rhyann Deline, DC
• Dentistry of West Bend, LTD.
• Jennifer Depagter, CRNA
• Diagnostic Services of Washington County SC
• Diane Lapota Foundational Wellness LLC
• William Dick, OD
• Elizabeth Anne Dieringer, MPT
• Ajit B Divgi, MD

• Dermatology Physician in West Bend, WI
• Providers in West Bend, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.