Forefront Dermatology, S.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FOREFRONT DERMATOLOGY, S.C.

Practice address

19950 Dodd Blvd
Suite 102
Lakeville, MN 55044

Phone

(612) 920-7546

Fax

(612) 920-7548

NPI assigned

Aug 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Betsy J Wernli, MD

Title

President

Phone

(960) 482-0671

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Rogers, MN
  • NPI 1114393295

  O20150901000903

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Woodbury, MN
  • NPI 1164898250

  O20150901000903

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Edina, MN
  • NPI 1245606326

  O20150901000903

  Same enrollment
• Forefront Dermatology, S.C.

  • Plastic Surgery Physician
  • Minneapolis, MN
  • NPI 1528951035

  O20150901000903

  Same enrollment

Practitioners 3

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

• Rachelle Eljazzar, MD

  • Plastic and Reconstructive Surgery Physician
  • Minneapolis, MN
  • NPI 1982261525
  Medicare reassignment Care Compare group NPD
• Brooke Alexandra Stein Moss, PA-C

  • Physician Assistant
  • Rogers, MN
  • NPI 1316346950
  Medicare reassignment Care Compare group
• Diana K Cohen, M.D.

  • Dermatology Physician
  • Hudson, WI
  • NPI 1467896498

  MN

  Medicare reassignment NPD

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1659747731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9016",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19950 DODD BLVD",
            "address_2": "SUITE 102",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "55044",
            "telephone_number": "612-920-7546",
            "fax_number": "612-920-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-12",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "WERNLI",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "960-482-0671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Avery Flicek
• Natasha Flores
• Focused Eye Care, PA
• Brian John Foley
• Scott Fontana, O.D.
• Katarina Klementina Foster, D.D.S
• Michelle Frauenshuh, MA LMFT
• Cindy Frederick, LMFT
• Kyle Matthew Fredrickson, MD
• Jamie R Freier, MS, RDN, LD, CNSC

• Dermatology Physician in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.