NPIMap

Organization Active NPI

Near Me Dermatology PLLC

  • Dermatology Physician
  • West Seneca, NY
National Provider Identifier
1326712209
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NEAR ME DERMATOLOGY PLLC
Practice address
550 Orchard Park Rd
West Seneca, NY 14224-2646
Phone
(716) 650-5720
Fax
(716) 650-4618
NPI assigned
Aug 4, 2021
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Youn Jea Kim, NPNPI 1376908442
Title
NP
Phone
(716) 650-5720

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

550 Orchard Park Rd
West Seneca, NY 14224-2646

Mailing address

550 Orchard Park Rd
West Seneca, NY 14224-2646
Phone (716) 650-5720

Other practice location 1

1170 Maple Rd
Williamsville, NY 14221
Phone (213) 880-2538

Other practice location 2

609 Central Ave
Dunkirk, NY 14048-2538
Phone (716) 650-5720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220125000410 NY Part B Supplier - Clinic/Group Practice 5799177747 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Buffalo, NY; Dunkirk, NY; West Seneca, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

609 Central Ave
Dunkirk, NY 14048
Phone (716) 363-6960

Practitioners & affiliated clinicians

Practitioners 3

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": "1628035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1326712209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 ORCHARD PARK RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142242646",
            "telephone_number": "716-650-5720",
            "fax_number": "716-650-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 ORCHARD PARK RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142242646",
            "telephone_number": "716-650-5720",
            "fax_number": "716-650-4618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1170 Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsville",
            "state": "NY",
            "postal_code": "14221",
            "country_code": "US",
            "telephone_number": "213-880-2538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "609 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Dunkirk",
            "state": "NY",
            "postal_code": "140482538",
            "country_code": "US",
            "telephone_number": "716-650-5720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEAR ME DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-04",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YOUN JEA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "716-650-5720",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.