NPIMap

Organization Active NPI

Dermatology & Skin Surgery Center of York, LLC

  • MOHS-Micrographic Surgery Physician
  • York, PA
National Provider Identifier
1447453170
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
DERMATOLOGY & SKIN SURGERY CENTER OF YORK, LLC
Practice address
400 Pine Grove CMNS
York, PA 17403-5161
Phone
(717) 755-4422
Fax
(717) 755-2390
NPI assigned
Jun 8, 2007
Last updated
Dec 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Authorized official

Name
Dr. Natalie Ivana Bene, M.D.NPI 1164405353
Title
Medical Director
Phone
(717) 755-4422

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
MOHS-Micrographic Surgery Physician 207ND0101X NU Primary
Dermatopathology Physician 207ND0900X NU
Procedural Dermatology Physician 207NS0135X NU

Addresses

Primary practice location

400 Pine Grove CMNS
York, PA 17403-5161

Mailing address

400 Pine Grove CMNS
York, PA 17403-5161
Phone (717) 755-4422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070926000628 PA Part B Supplier - Clinic/Group Practice 0244323343 Receives reassigned benefits from 10 practitioners
Practice locations: York, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D1075515Dermatology Skin Surg Ctr of York LLC400 Pine Grove Commons, York, PA 17403ComplianceNov 7, 2027

National Provider Directory

National Provider Directory

Locations

2300 Pleasant Valley Rd
Bldg 1
York, PA 17402
Phone (717) 755-2020

Practitioners & affiliated clinicians

Practitioners 10

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": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1447453170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PINE GROVE CMNS",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035161",
            "telephone_number": "717-755-4422",
            "fax_number": "717-755-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PINE GROVE CMNS",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174035161",
            "telephone_number": "717-755-4422",
            "fax_number": "717-755-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & SKIN SURGERY CENTER OF YORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "BENE",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "IVANA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "717-755-4422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.