NPIMap

Organization Active NPI

Dermatology and Skin Surgery Center, Professional Association

  • Procedural Dermatology Physician
  • Florham Park, NJ
National Provider Identifier
1811129141
Registry record updated Oct 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
25MA0837050 Issued in NJ
Legal business name
DERMATOLOGY AND SKIN SURGERY CENTER, PROFESSIONAL ASSOCIATION
Practice address
220 Ridgedale Ave
Suite A3
Florham Park, NJ 07932-1348
Phone
(973) 301-9500
Fax
(973) 301-0435
NPI assigned
Aug 20, 2009
Last updated
Oct 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2009

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

Authorized official

Name
Dr. David Adam Kiken, M.D.NPI 1801004114
Title
Owner
Phone
(973) 301-9500

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X A89501 CA
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X 233992-1 NY
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X 25MA0837050 NJ Primary

Addresses

Primary practice location

220 Ridgedale Ave
Suite A3
Florham Park, NJ 07932-1348

Mailing address

220 Ridgedale Ave
Suite A3
Florham Park, NJ 07932-1348
Phone (973) 301-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091013000525 NJ Part B Supplier - Clinic/Group Practice 8426194036 Receives reassigned benefits from 5 practitioners
Practice locations: Florham Park, NJ

National Provider Directory

National Provider Directory

Locations

3461 US Highway 22 E
Bldg D
Branchburg, NJ 08876
Phone (908) 725-4777

220 Ridgedale Ave
Ste A3
Florham Park, NJ 07932
Phone (973) 466-6333

205 Ridgedale Ave
Ste 4
Florham Park, NJ 07932
Phone (973) 301-9500

407 Richmond Ave
Point Pleasant Beach, NJ 08742
Phone (201) 926-6151

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255305600000",
    "number": "1811129141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RIDGEDALE AVE",
            "address_2": "SUITE A3",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321348",
            "telephone_number": "973-301-9500",
            "fax_number": "973-301-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RIDGEDALE AVE",
            "address_2": "SUITE A3",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321348",
            "telephone_number": "973-301-9500",
            "fax_number": "973-301-0435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND SKIN SURGERY CENTER, PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-10-12",
        "status": "A",
        "authorized_official_last_name": "KIKEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-301-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A89501",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "233992-1",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NJ",
            "license": "25MA0837050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florham Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2009; 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.