Organization Active NPI

Jacob a Marder, DNP PA

Doing business as Flagler Dermatology

  • Dermatology Physician
  • West Palm Beach, FL
National Provider Identifier
1790489524
Registry record updated Mar 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
JACOB A MARDER, DNP PA
Doing business as
Flagler Dermatology
Practice address
1411 N Flagler Dr Ste 9000
West Palm Beach, FL 33401-3421
Phone
(561) 584-8460
Fax
(561) 935-5537
NPI assigned
Mar 27, 2023
Last updated
Mar 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2025

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

Authorized official

Name
Dr. Jacob Ariel Marder, DNPNPI 1154934149
Title
President
Phone
(561) 584-8460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

1411 N Flagler Dr Ste 9000
West Palm Beach, FL 33401-3421

Mailing address

1411 N Flagler Dr Ste 9000
West Palm Beach, FL 33401-3421
Phone (561) 584-8460

Other names 1

  • FLAGLER DERMATOLOGY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230918000039 FL Part B Supplier - Clinic/Group Practice 8820452394 Receives reassigned benefits from 3 practitioners
Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742688000000",
    "number": "1790489524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR STE 9000",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013421",
            "telephone_number": "561-584-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FLAGLER DR STE 9000",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013421",
            "telephone_number": "561-584-8460",
            "fax_number": "561-935-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB A MARDER, DNP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2025-03-23",
        "certification_date": "2025-03-23",
        "status": "A",
        "authorized_official_last_name": "MARDER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "ARIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-584-8460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLAGLER DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2025; 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.