Organization Active NPI

Alpha Dermatology of Pennsylvania, LLC

  • Dermatology Physician
  • Sellersville, PA
National Provider Identifier
1477986925
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ALPHA DERMATOLOGY OF PENNSYLVANIA, LLC
Practice address
670 Lawn Ave Ste a
Sellersville, PA 18960-1571
Phone
(215) 257-0196
Fax
(215) 257-1211
NPI assigned
Aug 19, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Daniel I Shrager, M.D.NPI 1396784120
Title
Physician
Phone
(215) 257-0196

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 Primary

Addresses

Primary practice location

670 Lawn Ave Ste a
Sellersville, PA 18960-1571

Mailing address

670 Lawn Ave Ste a
Sellersville, PA 18960-1571
Phone (215) 257-0196

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140401000173 PA Part B Supplier - Clinic/Group Practice 9931330156 Receives reassigned benefits from 5 practitioners
Practice locations: New Hope, PA; Sellersville, 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
39D2199824Alpha Dermatology of PA, LLC670 Lawn Ave, Ste 1a, Sellersville, PA 18960Certificate of waiverNov 10, 2026

National Provider Directory

National Provider Directory

Locations

408 York Rd
Ste A
New Hope, PA 18938
Phone (215) 862-6000

670 Lawn Ave
Ste A
Sellersville, PA 18960
Phone (215) 257-0196

817 Lawn Ave
#D
Sellersville, PA 18960
Phone (215) 257-0196

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1477986925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 LAWN AVE STE A",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189601571",
            "telephone_number": "215-257-0196",
            "fax_number": "215-257-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 LAWN AVE STE A",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189601571",
            "telephone_number": "215-257-0196",
            "fax_number": "215-257-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA DERMATOLOGY OF PENNSYLVANIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHRAGER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "215-257-0196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sellersville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.