Individual provider Active NPI

John Michael Williams, MD

  • Dermatology Physician
  • Summit, NJ
National Provider Identifier
1457389678
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA08118400 Issued in NJ
Practice address
33 Overlook Rd Ste 202
Summit, NJ 07901-3562
Phone
(908) 598-1300
Fax
(908) 598-1301
NPI assigned
Jun 28, 2006
Last updated
Jan 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA08118400 NJ Primary

Addresses

Primary practice location

33 Overlook Rd Ste 202
Summit, NJ 07901-3562

Mailing address

33 Overlook Rd Ste 202
Summit, NJ 07901-3562
Phone (908) 598-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080327000062 NJ Practitioner - Dermatology 3870565435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Drexel University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

33 Overlook Rd
Summit, NJ 07901-3570
Phone (908) 598-1300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Melanoma (skin cancer) excision202
Removal of tissue74
Removal of skin lesions1197
Removal of nail tissue145
Removal or shaving of skin growth318
Skin biopsy75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA08118400NJMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Care and Surgery Center LLC Dermatology CurrentSince Jan 1, 2008 Accepting new patients
Brigham Community Practices Past Accepting new patients

Locations

33 Overlook Rd
Ste 202
Summit, NJ 07901
Phone (908) 598-1300

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1457389678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD STE 202",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013562",
            "telephone_number": "908-598-1300",
            "fax_number": "908-598-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD STE 202",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013562",
            "telephone_number": "908-598-1300",
            "fax_number": "908-598-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA08118400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.