Organization Active NPI

Panzer Dermatology Associates

  • Specialist
  • Newark, DE
National Provider Identifier
1740201995
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1989022601 Issued in DE
Legal business name
PANZER DERMATOLOGY ASSOCIATES
Practice address
537 Stanton Christiana Rd
Suite 107
Newark, DE 19713-2146
Phone
(302) 633-7550
Fax
(302) 225-3774
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Ms. Mary Pat Kwoka, MSMHC
Title
Practice Administrator
Phone
(302) 633-7550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 1989022601 DE Primary

Addresses

Primary practice location

537 Stanton Christiana Rd
Suite 107
Newark, DE 19713-2146

Mailing address

537 Stanton Christiana Rd
Suite 107
Newark, DE 19713-2146
Phone (302) 633-7550

Other identifiers 1

IdentifierTypeStateIssuer
000079402MedicaidDE

Other names 1

  • Panzer Dermatology & Cosmetic Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031222000106 DE Part B Supplier - Clinic/Group Practice 6103724745 Receives reassigned benefits from 32 practitioners
Practice locations: Newark, DE

National Provider Directory

National Provider Directory

Locations

537 Stanton Christiana Rd
Ste 109
Newark, DE 19713
Phone (302) 225-0177

537 Stanton Christiana Rd
#A
Newark, DE 19713
Phone (302) 633-7550

537 Stanton Christiana Rd
Ste 207207
Newark, DE 19713

537 Stanton Christiana Rd
Ste 111
Newark, DE 19713
Phone (302) 998-0741

1092 Old Churchmans Rd
#A
Newark, DE 19713
Phone (302) 633-7550

537 Stanton Christiana Rd
Ste 207
Newark, DE 19713
Phone (302) 633-7550

537 Stanton Christiana Rd
Ste 107
Newark, DE 19713
Phone (302) 633-7550

800 Delaware Ave
Fl 3
Wilmington, DE 19801

Practitioners & affiliated clinicians

Practitioners 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1740201995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 STANTON CHRISTIANA RD",
            "address_2": "SUITE 107",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132146",
            "telephone_number": "302-633-7550",
            "fax_number": "302-225-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 STANTON CHRISTIANA RD",
            "address_2": "SUITE 107",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132146",
            "telephone_number": "302-633-7550",
            "fax_number": "302-225-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANZER DERMATOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "KWOKA",
        "authorized_official_first_name": "MARY PAT",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "302-633-7550",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSMHC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "DE",
            "license": "1989022601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000079402",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Panzer Dermatology & Cosmetic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.