Integrated Dermatology of Mass Ave, LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

INTEGRATED DERMATOLOGY OF MASS AVE, LLC

Practice address

4910 Massachusetts Ave NW Ste 308
Washington, DC 20016-4382

Phone

(202) 695-1000

Fax

(202) 503-1791

NPI assigned

Mar 13, 2018

Last updated

May 1, 2018By 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

Adam S. Plotkin

Title

Authorized Official

Phone

(561) 314-2000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 7

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.

• Wallace Ramsey Nozile, MD

  • Dermatology Physician
  • Washington, DC
  • NPI 1093101107

  Mohs-Micrographic Surgery

  Medicare reassignment Care Compare group NPD
• Stephen Suah, M.D.

  • Dermatology Physician
  • Washington, DC
  • NPI 1538554951
  Medicare reassignment Care Compare group NPD
• Raina Bembry, MD

  • Dermatology Physician
  • Fairfax, VA
  • NPI 1942769724

  DC

  Medicare reassignment Care Compare group NPD
• Carolyn Nalae Yi

  • Physician Assistant
  • Washington, DC
  • NPI 1710655857
  Medicare reassignment Care Compare group
• Todd E Perkins, MD

  • Dermatology Physician
  • Washington, DC
  • NPI 1982641148
  Medicare reassignment NPD
• Suzanne French, NP

  • Adult Health Nurse Practitioner
  • Washington, DC
  • NPI 1811215098
  NPD (past)
• Anna Edhegard, MD

  • Dermatology Physician
  • Morganton, NC
  • NPI 1164657391

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1417450883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-314-2000",
            "fax_number": "561-431-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 MASSACHUSETTS AVE NW STE 308",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164382",
            "telephone_number": "202-695-1000",
            "fax_number": "202-503-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED DERMATOLOGY OF MASS AVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "PLOTKIN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "561-314-2000"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Community Services, Inc.
• Integrated Community Services, Inc.
• Integrated Dermatology of 19TH Street LLC
• Integrated Dermatology of I Street, LLC
• Integrated Dermatology of K Street LLC
• Integrated Health Services D.C., LLC (Leyla M Sandler, LICSW)
• Integrated Vision Healthcare Inc
• Integrated Wellness DC, LLC
• Integrative Behavioral Supports Inc.
• Integrative CBT PLLC

• MOHS-Micrographic Surgery Physician in Washington, DC
• Providers in Washington, DC by specialty
• MOHS-Micrographic Surgery Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.