Keystone Dermatology Partners, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

KEYSTONE DERMATOLOGY PARTNERS, LLC

Practice address

216 Mall Blvd Ste 101
King of Prussia, PA 19406-2923

Phone

(215) 390-1449

Fax

(215) 390-1449

NPI assigned

Apr 10, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Clifford Scott Perlis, M.D.NPI 1548251481

Title

President

Phone

(215) 356-6942

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 4

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

• Clifford Scott Perlis, M.D.

  • Procedural Dermatology Physician
  • Philadelphia, PA
  • NPI 1548251481
  Medicare reassignment NPD Authorized official
• Amy Lynn Levinson, FNP-BC

  • Nurse Practitioner
  • Willow Grove, PA
  • NPI 1154743458
  Medicare reassignment NPD
• Alicia C. Walter, PA-C

  • Physician Assistant
  • King of Prussia, PA
  • NPI 1346670619
  Medicare reassignment
• Magdalene Y Ho, MD

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1760489710
  NPD (past)

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1801329552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 MALL BLVD STE 101",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062923",
            "telephone_number": "215-390-1449",
            "fax_number": "215-390-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MALL BLVD STE 101",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062923",
            "telephone_number": "215-390-1449",
            "fax_number": "215-390-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE DERMATOLOGY PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "PERLIS",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-356-6942",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Varano DO Inc.
• Colleen Kenney
• Dawn Keown, CRNA
• Bonny Kepler
• Ketamine Treatment Centers of Princeton, LLC
• Keystone Neurocare LLC
• Keystone Spine and Sport LLC
• Urmi Khatri, OD
• Avina Khiatani, PH.D.
• Jessica Khoury, OD

• Dermatology Physician in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.