Adirondack Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2016181 Issued in NY

Legal business name

ADIRONDACK DERMATOLOGY PC

Practice address

1753 Route 3
Adirondack Dermatology PC
Plattsburgh, NY 12962

Phone

(518) 563-7546

Fax

(518) 562-5458

NPI assigned

Nov 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Dejordy, MDNPI 1427027549

Title

President

Phone

(518) 563-7546

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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.

• John O Dejordy, MD

  • Dermatology Physician
  • Morrisonville, NY
  • NPI 1427027549
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215003579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 ROUTE 3",
            "address_2": "ADIRONDACK DERMATOLOGY PC",
            "city": "MORRISONVILLE",
            "state": "NY",
            "postal_code": "12962",
            "telephone_number": "518-563-7546",
            "fax_number": "518-562-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 ROUTE 3",
            "address_2": "ADIRONDACK DERMATOLOGY PC",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "12962",
            "telephone_number": "518-563-7546",
            "fax_number": "518-562-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADIRONDACK DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEJORDY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-563-7546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "2016181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Marie Adams, LMSW
• Fatin Adams
• Richard N Adams Jr., DO
• Andrea J Addison-Sorey, PA
• Adirondack Assist, LLC
• Adirondack Elite Aesthetics PLLC
• Adirondack Family Chiropractic PC
• Adirondack Happiness Mental Health Counseling PLLC
• Adirondack Health Regional Medical, P.C.
• Adirondack Interventional Physiatry PC (Champlain Spine & Pain Mgt)

• Dermatology Physician in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.