Organization Active NPI

Phoenixville & Valley Forge Dermatology Associates, PC.

Doing business as Dermatology Assoc

  • Dermatology Physician
  • Phoenixville, PA
National Provider Identifier
1457333197
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
PHOENIXVILLE & VALLEY FORGE DERMATOLOGY ASSOCIATES, PC.
Doing business as
Dermatology Assoc
Practice address
1260 Valley Forge Road
Suite 101
Phoenixville, PA 19460
Phone
(610) 983-3980
Fax
(610) 983-3406
NPI assigned
Nov 17, 2005
Last updated
Oct 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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

Authorized official

Name
Mr. Peter J Motel, M.D.NPI 1538140900
Title
Owner
Phone
(610) 983-3980

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
Dermatology Physician 207N00000X NU
Dermatology Physician 207N00000X PA Primary

Addresses

Primary practice location

1260 Valley Forge Road
Suite 101
Phoenixville, PA 19460

Mailing address

1260 Valley Forge Road
Suite 101
Phoenixville, PA 19460
Phone (610) 983-3980

Other names 1

  • Dermatology Assoc Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050406000117 PA Part B Supplier - Clinic/Group Practice 2365499951 Receives reassigned benefits from 5 practitioners
Practice locations: Phoenixville, 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
39D2076698Phoenixville Valley Forge Dermatology Assoc1260 Valley Forge Road Suite 103, Phoenixville, PA 19460ComplianceMar 29, 2028

National Provider Directory

National Provider Directory

Locations

1260 Valley Forge Rd
Ste 101
Phoenixville, PA 19460
Phone (610) 983-3980

Practitioners & affiliated clinicians

Practitioners 6

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": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1457333197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 VALLEY FORGE ROAD",
            "address_2": "SUITE 101",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "19460",
            "telephone_number": "610-983-3980",
            "fax_number": "610-983-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 VALLEY FORGE ROAD",
            "address_2": "SUITE 101",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "19460",
            "telephone_number": "610-983-3980",
            "fax_number": "610-983-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIXVILLE & VALLEY FORGE DERMATOLOGY ASSOCIATES, PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-17",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "MOTEL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-983-3980",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Assoc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenixville, PA

Sources for this page

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