Affiliated Dermatologists SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

AFFILIATED DERMATOLOGISTS SC

Practice address

1111 Delafield St Ste 308
Waukesha, WI 53188-3407

Phone

(262) 754-4488

NPI assigned

Jun 14, 2006

Organization subpart

No

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

Authorized official

Name

Kathleen Sarah Stokes, MD

Title

President

Phone

(262) 754-4488

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

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

• Affiliated Dermatologists

  • Dermatology Physician
  • Germantown, WI
  • NPI 1902205206

  O20050414000817

  Same enrollment
• Affiliated Dermatologists SC

  • Dermatology Physician
  • New Berlin, WI
  • NPI 1194711853

  O20050414000817

  Same enrollment
• Affiliated Dermatologists SC

  • Dermatology Physician
  • Brookfield, WI
  • NPI 1407849011

  O20050414000817

  Same enrollment
• Affiliated Dermatologists, SC

  • MOHS-Micrographic Surgery Physician
  • Oak Creek, WI
  • NPI 1316656721

  O20050414000817

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Steven M Schuckit, M.D.

  • Dermatology Physician
  • Brookfield, WI
  • NPI 1629395348

  Dermatology

  NPD
• Nicholas James Zajdel, MD

  • Dermatology Physician
  • Brookfield, WI
  • NPI 1629430210

  Dermatology

  NPD
• Gretchen Mary Zirbel, MD

  • Dermatology Physician
  • Brookfield, WI
  • NPI 1588658371

  Dermatology

  NPD

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1700829959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 W NORTH AVE STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054977",
            "telephone_number": "262-754-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST STE 308",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883407",
            "telephone_number": "262-754-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED DERMATOLOGISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "SARAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-754-4488",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21299500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF4745",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Marie Adrian, RN
• Advanced Bracing Plus LLC
• Advanced Dental Specialists, LLC
• Advanced Pain Management SC
• Aesthetic and Reconstructive Surgery Associates SC
• Omer Afzal, M.D.
• Ag Perio LLC
• Agpoon Medical Clinic, S.C.
• Perla P. Agpoon, M.D.
• Gregorio Aguilar Jr.

• All providers in Waukesha, WI
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.