NPIMap

Organization Active NPI

Siperstein Dermatology Group, PLLC

  • Dermatology Physician
  • Boynton Beach, FL
National Provider Identifier
1609101278
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME 100726 Issued in FL
Legal business name
SIPERSTEIN DERMATOLOGY GROUP, PLLC
Practice address
9897 Hagen Ranch Rd
Boynton Beach, FL 33472-7400
Phone
(561) 364-7774
Fax
(561) 364-7775
NPI assigned
Oct 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Authorized official

Name
Mrs. Jessica Ivy
Title
Practice Administrator
Phone
(561) 364-7774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X ME 100726 FL Primary

Addresses

Primary practice location

9897 Hagen Ranch Rd
Boynton Beach, FL 33472-7400

Mailing address

9897 Hagen Ranch Rd
Boynton Beach, FL 33472-7400
Phone (561) 364-7774

Other practice location 1

1401 N Federal Hwy
Boca Raton, FL 33432-1925
Phone (561) 955-8885

Other names 1

  • Siperstein Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100608000229 FL Part B Supplier - Clinic/Group Practice 3476683145 Receives reassigned benefits from 26 practitioners
Practice locations: Boca Raton, FL; Boynton Beach, FL

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
10D2041846Siperstein Dermatology LLC1401 N Federal Highway, Boca Raton, FL 33432ComplianceJul 22, 2026

National Provider Directory

National Provider Directory

Locations

1401 N Federal Hwy
Boca Raton, FL 33432
Phone (561) 364-7774

9897 Hagen Ranch Rd
Boynton Beach, FL 33437
Phone (561) 364-7774

1700 W Woolbright Rd
Ste 5
Boynton Beach, FL 33426
Phone (561) 364-7774

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1609101278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9897 HAGEN RANCH RD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334727400",
            "telephone_number": "561-364-7774",
            "fax_number": "561-364-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9897 HAGEN RANCH RD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334727400",
            "telephone_number": "561-364-7774",
            "fax_number": "561-364-7775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 N Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334321925",
            "country_code": "US",
            "telephone_number": "561-955-8885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIPERSTEIN DERMATOLOGY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "IVY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "561-364-7774",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME 100726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Siperstein Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Siperstein Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.