Novi Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

NOVI DERMATOLOGY PLLC

Practice address

44000 W 12 Mile Rd Ste 103
Novi, MI 48377

Phone

(248) 946-4787

Fax

(248) 716-5956

NPI assigned

Jul 3, 2017

Organization subpart

No

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

Authorized official

Name

Alice C Watson, MDNPI 1528146651

Title

Delegated Official

Phone

(248) 946-4787

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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.

• Alice C. Watson, M.D.

  • Dermatology Physician
  • Novi, MI
  • NPI 1528146651
  Medicare reassignment Care Compare group NPD Authorized official
• Ayad Edward Abrou, M.D.

  • MOHS-Micrographic Surgery Physician
  • Rochester Hills, MI
  • NPI 1457305815
  Medicare reassignment Care Compare group NPD
• Lisa Ann Barron, M.D.

  • Dermatology Physician
  • Novi, MI
  • NPI 1639270432
  Medicare reassignment Care Compare group NPD
• Adrienne Fasbinder Vassallo, MSN, APRN, NP-C

  • Gerontology Nurse Practitioner
  • Bingham Farms, MI
  • NPI 1447998760

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Nadeline A Dawisha, PA-C

  • Physician Assistant
  • Rochester Hills, MI
  • NPI 1972271229
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1245751007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44000 W 12 MILE RD STE 103",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772646",
            "telephone_number": "248-946-4787",
            "fax_number": "248-308-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44000 W 12 MILE RD STE 103",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "248-946-4787",
            "fax_number": "248-716-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVI DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-03",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "248-946-4787",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Novi Arch Supports Inc
• Novi Attendant Care LLP
• Novi Chiropractic Clinic PC
• Novi Dental Care PC
• Novi Dentists PLLC
• Novi Discount Pharmacy LLC
• Novi DPT LLC
• Novi Family Dental Center PC
• Novi Family Dentist, PLLC
• Novi Health & Wellness PLLC

• Dermatology Physician in Novi, MI
• Providers in Novi, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.