Organization Active NPI

Dermatology Associates of Delaware Valley PC

  • Dermatology Physician
  • Newtown Square, PA
National Provider Identifier
1821160011
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD07523L Issued in PA
Legal business name
DERMATOLOGY ASSOCIATES OF DELAWARE VALLEY PC
Practice address
3501 W Chester Pike
Unit 205
Newtown Square, PA 19073-3704
Phone
(610) 325-5553
Fax
(610) 325-5532
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Authorized official

Name
Dr. Daphne Elizabeth Coch Benstock, MD
Title
President
Phone
(610) 325-5553

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MD07523L PA Primary

Addresses

Primary practice location

3501 W Chester Pike
Unit 205
Newtown Square, PA 19073-3704

Mailing address

3501 W Chester Pike Ste 202
Newtown Square, PA 19073-3708
Phone (610) 325-5553

Other identifiers 1

IdentifierTypeStateIssuer
MD070523LOtherPAMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331001236 PA Part B Supplier - Clinic/Group Practice 6305838277 Receives reassigned benefits from 2 practitioners
Practice locations: Newtown Square, PA

National Provider Directory

National Provider Directory

Locations

3501 West Chester Pike
Ste 205
Newtown Square, PA 19073
Phone (610) 325-5553

3501 West Chester Pike
Ste 202
Newtown Square, PA 19073
Phone (610) 325-5553

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1821160011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 W CHESTER PIKE STE 202",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733708",
            "telephone_number": "610-325-5553",
            "fax_number": "610-325-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 W CHESTER PIKE",
            "address_2": "UNIT 205",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733704",
            "telephone_number": "610-325-5553",
            "fax_number": "610-325-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF DELAWARE VALLEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "COCH BENSTOCK",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-325-5553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD07523L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD070523L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.