Affiliated Troy Dermatologists, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

405985 Issued in MI

Legal business name

AFFILIATED TROY DERMATOLOGISTS, PLLC

Practice address

4600 Investment Dr
Ste 260
Troy, MI 48098-6365

Phone

(248) 267-5020

Fax

(248) 267-5021

NPI assigned

Aug 11, 2005

Last updated

Aug 7, 2015By 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. Marcia Brooks Cardelli, M.D.NPI 1689787939

Title

M.D.

Phone

(248) 267-5020

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

Locations

Practitioners 9

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.

• Marcia Brooks Cardelli, M.D.

  • Specialist
  • Troy, MI
  • NPI 1689787939
  Medicare reassignment NPD Authorized official
• Snehal R Desai, M.D.

  • Dermatology Physician
  • Troy, MI
  • NPI 1255549218
  Medicare reassignment Care Compare group NPD
• Traci Kimbrough, M.D.

  • Specialist
  • Troy, MI
  • NPI 1235242587
  Medicare reassignment Care Compare group NPD
• Megan S Jajou, PA

  • Medical Physician Assistant
  • Troy, MI
  • NPI 1710338090
  Medicare reassignment Care Compare group
• Kayla Marie Mayer

  • Physician Assistant
  • Grand Blanc, MI
  • NPI 1770217150
  Medicare reassignment Care Compare group
• Holly Vanderwerff

  • Physician Assistant
  • Troy, MI
  • NPI 1194195966
  Medicare reassignment Care Compare group
• Chelsea Navarro, P.A. C

  • Physician Assistant
  • Petoskey, MI
  • NPI 1740520980
  Medicare reassignment
• Rachel Sobek, PA

  • Physician Assistant
  • Vero Beach, FL
  • NPI 1457956732

  MI

  Medicare reassignment
• Eve Kehrer

  • Nurse Practitioner
  • Clarkston, MI
  • NPI 1427161751
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1467454264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 INVESTMENT DR",
            "address_2": "STE 260",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986365",
            "telephone_number": "248-267-5020",
            "fax_number": "248-267-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 INVESTMENT DR",
            "address_2": "STE 260",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986365",
            "telephone_number": "248-267-5020",
            "fax_number": "248-267-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED TROY DERMATOLOGISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "CARDELLI",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "248-267-5020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "405985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Troy, MI
• Providers in Troy, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; 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.