Elizabeth Rose Botham, M.D.
Individual provider Active NPI Dermatology Physician · Hackettstown, NJ
NPI 1669732467 · NPPES record last updated Feb 12, 2025
Key facts
- NPI
- 1669732467
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 25MA09634800 (NJ)
- Practice address
- 108 Bilby Rd
Hackettstown, NJ 07840-4174 - Phone
- (908) 509-1938
- Fax
- (908) 441-2402
- NPI assigned
- May 25, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Natural Image Skin Center
Practice addresses (Care Compare)
108 Bilby Rd
Suite 202
Hackettstown, NJ 07840-4174
Phone (908) 509-1938
Hospital & facility affiliations
- Ahs Hospital Corp
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 603 |
| Skin biopsy | 480 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170929000678 | NJ | Practitioner - Dermatology | 5799050837 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09634800 | NJ | MD | Dermatology Physician |
| 285736 | NY | MD | Pediatric Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Natural Image Skin Center | Dermatology | Current |
Accepting new patients |
| The Radiology Group of New Jersey, LLC | Past |
Accepting new patients |
Locations
108 Bilby Rd
Ste 202
Hackettstown, NJ 07840
Phone (908) 509-1938
108 Bilby Rd
Hackettstown, NJ 07840
Phone (908) 251-9419
201 S Livingston Ave
Ste 1C
Livingston, NJ 07039
Phone (908) 509-1938
Interoperability endpoints
- eghazi189699@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dermatology Physician | 207NP0225X | 285736 | NY | |
| Dermatology Physician | 207N00000X | 25MA09634800 | NJ | Yes |
Addresses
Primary practice location
108 Bilby Rd
Hackettstown, NJ 07840-4174
Mailing address
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Other providers in Hackettstown, NJ
- Sarah Ann Biron
- Simone Blount
- Steven F. Bogart
- Bruce Bonanno
- Alyssa Borozan
- Christine M. Bove
- Jamie Lynn Bovino
- Daphne Boyd-Bermingham
- Alison Jennifer Bratman
- Bridge to Change LLC
All providers in Hackettstown, NJ · Dermatology Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.