NPIMap

Organization Active NPI

Associates in Medical and Surgical Dermatology, P.a.

  • Legal Medicine
  • Naples, FL
National Provider Identifier
1275538274
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
Legal business name
ASSOCIATES IN MEDICAL AND SURGICAL DERMATOLOGY, P.A.
Practice address
9125 Corsea del Fontana Way
# 100
Naples, FL 34109-4396
Phone
(239) 598-4004
Fax
(239) 598-4713
NPI assigned
Jun 16, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Seth Goodman, M.D.NPI 1396770848
Title
President
Phone
(239) 598-4004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X NU Primary

Addresses

Primary practice location

9125 Corsea del Fontana Way
# 100
Naples, FL 34109-4396

Mailing address

9125 Corsea del Fontana Way
# 100
Naples, FL 34109-4396
Phone (239) 598-4004

Other identifiers 3

IdentifierTypeStateIssuer
04756OtherFLGOODMAN BLUE CROSS #
45192OtherFLGROUP BLUE CROSS #
42568OtherFLTUCKER BLUE CROSS #

National Provider Directory

National Provider Directory

Locations

5811 Pelican Bay Blvd
Ste 308
Naples, FL 34108
Phone (239) 598-4004

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275538274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9125 CORSEA DEL FONTANA WAY",
            "address_2": "# 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341094396",
            "telephone_number": "239-598-4004",
            "fax_number": "239-598-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 CORSEA DEL FONTANA WAY",
            "address_2": "# 100",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341094396",
            "telephone_number": "239-598-4004",
            "fax_number": "239-598-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN MEDICAL AND SURGICAL DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-598-4004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOODMAN BLUE CROSS #",
            "identifier": "04756",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BLUE CROSS #",
            "identifier": "45192",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUCKER BLUE CROSS #",
            "identifier": "42568",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.