Individual provider Active NPI

Nicole Papastathis Huffman, M.D.

  • Dermatology Physician
  • Northbrook, IL
National Provider Identifier
1740448927
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036.130234 Issued in IL
Practice address
400 Skokie Blvd
Suite 475
Northbrook, IL 60062-2816
Phone
(847) 272-4433
Fax
(847) 272-4434
NPI assigned
May 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036.130234 IL Primary

Addresses

Primary practice location

400 Skokie Blvd
Suite 475
Northbrook, IL 60062-2816

Mailing address

400 Skokie Blvd
Suite 475
Northbrook, IL 60062-2816
Phone (847) 272-4433

Other names 1

  • Dr. Nicole Papastathis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120628000083 IL Practitioner - Dermatology 5991960858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York Medical College, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Partners of the North Shore LLCGroup PAC ID 2264427251, 12 clinicians

Practice addresses (Care Compare)

400 Skokie Blvd
Suite 475
Northbrook, IL 60062-7930
Phone (847) 272-4433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions849
Removal or shaving of skin growth33
Skin biopsy227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.130234ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Partners of the North Shore LLC Dermatology CurrentSince Aug 1, 2012 Accepting new patients

Locations

400 Skokie Blvd
Ste 475
Northbrook, IL 60062
Phone (847) 272-4433

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1211587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1740448927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SKOKIE BLVD",
            "address_2": "SUITE 475",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622816",
            "telephone_number": "847-272-4433",
            "fax_number": "847-272-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SKOKIE BLVD",
            "address_2": "SUITE 475",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622816",
            "telephone_number": "847-272-4433",
            "fax_number": "847-272-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "NICOLE",
        "middle_name": "PAPASTATHIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-24",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.130234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "PAPASTATHIS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.