Livonia Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LIVONIA DERMATOLOGY PLLC

Practice address

14801 Farmington Rd
Livonia, MI 48154-5429

Phone

(734) 542-8100

Fax

(734) 542-8168

NPI assigned

Jan 24, 2007

Last updated

Dec 6, 2011By 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

Dr. David Pegouske, M.D.NPI 1932201183

Title

Owner

Phone

(734) 542-8100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 5

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.

• David Pegouske, M.D.

  • Dermatology Physician
  • Livonia, MI
  • NPI 1932201183
  Medicare reassignment Care Compare group NPD Authorized official
• Mark Goralewski, MD

  • Dermatology Physician
  • Livonia, MI
  • NPI 1013395961
  Medicare reassignment Care Compare group NPD
• Stephanie Andrea Helminiak, PA-C

  • Medical Physician Assistant
  • Rochester Hills, MI
  • NPI 1043785959
  Medicare reassignment Care Compare group
• Jennifer Eskildsen, FNP-C

  • Family Nurse Practitioner
  • Livonia, MI
  • NPI 1649098864
  Medicare reassignment NPD
• Christopher Anthony Messana, D.O.

  • Dermatology Physician
  • Parker, CO
  • NPI 1720220890
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1457406217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14801 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545429",
            "telephone_number": "734-542-8100",
            "fax_number": "734-542-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14801 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545429",
            "telephone_number": "734-542-8100",
            "fax_number": "734-542-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVONIA DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "PEGOUSKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-542-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Livonia Care Pharmacy Inc (Livonia Care Pharmacy)
• Livonia Chiropractic, PC
• Livonia Cosmatic and Implant Dental Center
• Livonia Dental Care
• Livonia Dental Office
• Livonia Diagnostic Center,P.C.
• Livonia Drugs Inc. (Livonia Drugs)
• Livonia Emergency Physicians PLLC
• Livonia Express Pharmacy LLC
• Livonia Family Pharmacy LLC (Livonia Family Pharmacy)

• Dermatology Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.