NPIMap

Organization Active NPI

Philadelphia Dermatology Associates, PC

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1861491243
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD028614L Issued in PA
Legal business name
PHILADELPHIA DERMATOLOGY ASSOCIATES, PC
Practice address
220 S 8TH St
Philadelphia, PA 19107-5505
Phone
(215) 928-1493
Fax
(215) 928-1786
NPI assigned
Jul 19, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul R Gross, MDNPI 1558360560
Title
President
Phone
(215) 928-1493

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD028614L PA Primary

Addresses

Primary practice location

220 S 8TH St
Philadelphia, PA 19107-5505

Mailing address

220 S 8TH St
Philadelphia, PA 19107-5505
Phone (215) 928-1493

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": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861491243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S 8TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075505",
            "telephone_number": "215-928-1493",
            "fax_number": "215-928-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S 8TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075505",
            "telephone_number": "215-928-1493",
            "fax_number": "215-928-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA DERMATOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-928-1493",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD028614L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.