Active NPI
Affiliated Dermatologists SC
- Dermatology Physician
- Waukesha, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- 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
- Last updated
- May 28, 2021
- Organization subpart
- No
NPPES NPI Registry
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
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
1111 Delafield St Ste 308
Waukesha, WI 53188-3407
Mailing address
13800 W North Ave Ste 100
Brookfield, WI 53005-4977
Phone (262) 754-4488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050414000817 | WI | Part B Supplier - Clinic/Group Practice | 8123065794 |
Receives reassigned benefits from 16 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Brookfield, WI; Germantown, WI; Oak Creek, WI |
Other NPIs on the same Medicare enrollment 4
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- MOHS-Micrographic Surgery Physician
- Oak Creek, WI
- NPI 1316656721
O20050414000817
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D1055919 | Affiliated Dermatologists SC | Compliance | Nov 2, 2026 |
National Provider Directory
National Provider DirectoryLocations
N96W17035 Division Rd
Germantown, WI 53022
Phone (262) 754-4488
1111 Delafield St
Ste 308
Waukesha, WI 53188
Phone (262) 542-4251
1111 Delafield St
Ste 327
Waukesha, WI 53188
Phone (262) 239-7070
Practitioners & affiliated clinicians
Practitioners 6
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.
-
- Dermatology Physician
- Brookfield, WI
- NPI 1578556106
-
- Dermatology Physician
- Brookfield, WI
- NPI 1629395348
-
- Dermatology Physician
- Brookfield, WI
- NPI 1629430210
-
- Dermatology Physician
- Brookfield, WI
- NPI 1588658371
-
- Dermatology Physician
- Brookfield, WI
- NPI 1528562956
-
- Physician Assistant
- Waukesha, WI
- NPI 1215341920
NPI Registry JSON
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": [],
"endpoints": [],
"other_names": []
}
Other providers in Waukesha, WI
- Shelley Marie Adrian, RN
- Advanced Bracing Plus LLC
- Advanced Dental Specialists, LLC (Advanced Dental Specialists Stone Ridge)
- 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.
Sources for this page
- 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.