Dockside Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DOCKSIDE DERMATOLOGY LLC

Practice address

8601 Veterans Hwy Ste 201
Millersville, MD 21108-1566

Phone

(410) 934-5400

Fax

(410) 934-0141

NPI assigned

Feb 9, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Lesley Sutherland, MDNPI 1275953309

Title

Owner

Phone

(410) 533-4200

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Practitioners 5

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

• Lesley Anne Sutherland, MD

  • Dermatology Physician
  • Millersville, MD
  • NPI 1275953309
  Medicare reassignment Care Compare group NPD Authorized official
• Natalia Fontecilla Biles, MD

  • Dermatology Physician
  • Millersville, MD
  • NPI 1588169395
  Medicare reassignment Care Compare group NPD
• Stephanie Clements, MD

  • MOHS-Micrographic Surgery Physician
  • Millersville, MD
  • NPI 1295198646

  Dermatology

  Medicare reassignment Care Compare group NPD
• Alexandra Napoli Crosswhite, PA-C

  • Physician Assistant
  • Millersville, MD
  • NPI 1164949053
  Medicare reassignment Care Compare group
• Rachel Grabill Midwinter, PA

  • Medical Physician Assistant
  • Millersville, MD
  • NPI 1104450188
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679788800000",
    "number": "1194479972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY STE 201",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081566",
            "telephone_number": "410-934-5400",
            "fax_number": "410-934-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY STE 201",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081566",
            "telephone_number": "410-934-5400",
            "fax_number": "410-934-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCKSIDE DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2023-03-26",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "SUTHERLAND",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-533-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah a. Wahl Physical Therapy
• Miranda N Demers, LGPC
• Dentaproservices
• Devon Stokes, PHD, LLC
• Nathan Dickerson Jr., LCPC
• Kelly Dohony, LMSW
• Virginia Lepori Dolan
• Kelly Jeanne Dominic, LCPC
• Kimberly Donahue
• Jessica Catherine Donatelli

• Dermatology Physician in Millersville, MD
• Providers in Millersville, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2023; 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.