NJ Certified Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

NJ CERTIFIED DERMATOLOGY PC

Doing business as

Dedicated Dermatology

Practice address

2895 Hamilton Blvd Ste 202
Allentown, PA 18104-6172

Phone

(732) 456-7777

Fax

(848) 251-2189

NPI assigned

Jun 1, 2016

Last updated

Jun 6, 2023By 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

Lawrence L AndersonNPI 1134159627

Title

MD/Owner

Phone

(903) 521-6143

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• DEDICATED DERMATOLOGY Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• NJ Certified Dermatology PC

  • Dermatology Physician
  • Neptune, NJ
  • NPI 1003263807

  9931492287

  Same PAC ID

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 47

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.

• Jasmine Badillo, CRNP

  • Family Nurse Practitioner
  • Easton, PA
  • NPI 1881234334
  Medicare reassignment Care Compare group NPD
• Loanna T Nguyen, FNP

  • Family Nurse Practitioner
  • Allentown, PA
  • NPI 1790333458
  Medicare reassignment Care Compare group NPD
• John Peters

  • MOHS-Micrographic Surgery Physician
  • Villanova, PA
  • NPI 1598180309

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Lawrence Lazelle Anderson, MD

  • Dermatology Physician
  • Tyler, TX
  • NPI 1134159627

  PA

  Medicare reassignment NPD Authorized official
• Timothy Patrick Kelly, CRNP

  • Family Nurse Practitioner
  • Neptune, NJ
  • NPI 1164193751

  PA

  Medicare reassignment Care Compare group NPD
• E Andrew Leyco Sotomango, PA-C

  • Physician Assistant
  • Allentown, PA
  • NPI 1356976229
  Medicare reassignment Care Compare group
• Marisa Frances Baldassano, M.D.

  • Dermatopathology Physician
  • Lower Gwynedd, PA
  • NPI 1013965011
  Medicare reassignment NPD
• Conrad Joseph Benedetto Jr., D.O.

  • MOHS-Micrographic Surgery Physician
  • Drexel Hill, PA
  • NPI 1154718849
  Medicare reassignment NPD
• Julie M Cherubini, CRNP

  • Family Nurse Practitioner
  • Jenkintown, PA
  • NPI 1235765009
  Medicare reassignment NPD
• Avi Bitterman

  • Dermatopathology Physician
  • Woodmere, NY
  • NPI 1851755490

  Dermatology, PA

  Medicare reassignment NPD
• Ryan Karmouta, MD, MBA

  • Dermatology Physician
  • Salem, NH
  • NPI 1316441066

  PA

  Medicare reassignment NPD
• Peter Lapis, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Forked River, NJ
  • NPI 1164604153

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1326496241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 LAKEWOOD RD STE 16",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087553287",
            "telephone_number": "732-456-7777",
            "fax_number": "848-251-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 HAMILTON BLVD STE 202",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181046172",
            "telephone_number": "732-456-7777",
            "fax_number": "848-251-2189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2895 Hamilton Blvd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181046172",
            "country_code": "US",
            "telephone_number": "732-456-7777",
            "fax_number": "848-251-2189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "281 N 12th St Ste A",
            "address_purpose": "LOCATION",
            "city": "Lehighton",
            "state": "PA",
            "postal_code": "182351129",
            "country_code": "US",
            "telephone_number": "732-456-7777",
            "fax_number": "848-251-2189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 E Brown St Lowr Level",
            "address_purpose": "LOCATION",
            "city": "East Stroudsburg",
            "state": "PA",
            "postal_code": "183013012",
            "country_code": "US",
            "telephone_number": "732-456-7777",
            "fax_number": "848-251-2189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NJ CERTIFIED DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "903-521-6143"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "773906",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103608008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEDICATED DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rahul Nimmagadda
• Jason Ning, OD
• Joel C Ninos, MPT
• Supriya Niraula, MD
• Ioana Nistor, MD
• Julio Noboa, BS
• Robert Ellis Noecker, CRNA
• Bianca Noel
• Elizabeth Mintzer Nolan, PH.D.
• Megan Nolter, PA-C

• Dermatology Physician in Allentown, PA
• Providers in Allentown, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.