Dermatology of Boca LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY OF BOCA LLC

Practice address

4601 N Federal Hwy
Boca Raton, FL 33431-5133

Phone

(561) 314-2000

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Andrew Queen

Title

Manager

Phone

(561) 314-2000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

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

• Jeffrey Stuart Fromowitz, MD

  • Dermatology Physician
  • Boca Raton, FL
  • NPI 1265449003
  Medicare reassignment Care Compare group NPD
• Matthew D Goodwin, M.D.

  • Plastic Surgery Physician
  • Boca Raton, FL
  • NPI 1841407301
  Medicare reassignment Care Compare group NPD
• Stefanie Samantha Gold Mayer, PA-C

  • Physician Assistant
  • Boca Raton, FL
  • NPI 1003067786
  Medicare reassignment Care Compare group
• Lea Bellomo, MD

  • Dermatology Physician
  • Boca Raton, FL
  • NPI 1154749521
  Medicare reassignment NPD
• Alecia Shantel Folkes, DO

  • Dermatology Physician
  • Mount Dora, FL
  • NPI 1811358633
  NPD

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548374400000",
    "number": "1811062672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-314-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 N FEDERAL HWY",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334315133",
            "telephone_number": "561-314-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY OF BOCA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2019-01-25",
        "status": "A",
        "authorized_official_last_name": "QUEEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-314-2000"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Derkits, CRNP
• Jamisyn Danielle Derks
• Stephen Peter Dermarkarian
• Dermatology Clinic, PA
• Dermatology Group of Florida PA
• Dermpartners Inc
• Dermpath Lab LLC
• Dero Pain Specialists LLC
• Jennifer Deronville Stanley
• Derun Clinic

• Dermatology Physician in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; 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.

Verify at the official NPI Registry.