NPIMap

Organization Active NPI

Dermatology LTD

  • Dermatology Physician
  • Media, PA
National Provider Identifier
1477508257
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY LTD
Practice address
101 Chesley Dr
Suite 100
Media, PA 19063-1761
Phone
(610) 566-7111
Fax
(610) 891-6735
NPI assigned
May 23, 2006
Last updated
Jun 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Authorized official

Name
Dr. John Joseph Laskas Jr., M.D.NPI 1134127848
Title
President
Phone
(610) 566-7111

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PA Primary

Addresses

Primary practice location

101 Chesley Dr
Suite 100
Media, PA 19063-1761

Mailing address

101 Chesley Dr
Suite 100
Media, PA 19063-1761
Phone (610) 566-7111

Other identifiers 1

IdentifierTypeStateIssuer
827796OtherPABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000445 PA Part B Supplier - Clinic/Group Practice 0244120756 Receives reassigned benefits from 14 practitioners
Practice locations: Glen Mills, PA; Media, 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
39D0915347Dermatology LTD101 Chesley Dr Ste 100 Georgetown BLDG, Media, PA 19063ComplianceApr 15, 2027

National Provider Directory

National Provider Directory

Locations

1788 Wilmington W Chester Pike
Ste 2200
Glen Mills, PA 19342
Phone (610) 566-7111

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1477508257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CHESLEY DR",
            "address_2": "SUITE 100",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631761",
            "telephone_number": "610-566-7111",
            "fax_number": "610-891-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHESLEY DR",
            "address_2": "SUITE 100",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631761",
            "telephone_number": "610-566-7111",
            "fax_number": "610-891-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "LASKAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-566-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "827796",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.