Organization Active NPI

Dermatology Associates PC

  • Dermatology Physician
  • Birmingham, MI
National Provider Identifier
1871574954
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY ASSOCIATES PC
Practice address
800 S Adams Rd
Birmingham, MI 48009-7005
Phone
(248) 646-9597
Fax
(248) 646-4067
NPI assigned
Nov 7, 2005
Last updated
Oct 22, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Authorized official

Name
Dr. Martin Michael Abbrecht, MDNPI 1326038076
Title
President Dermatology Associates PC
Phone
(248) 646-9597

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 NU Primary

Addresses

Primary practice location

800 S Adams Rd
Birmingham, MI 48009-7005

Mailing address

800 S Adams Rd
Birmingham, MI 48009-7005
Phone (248) 646-9597

Other identifiers 1

IdentifierTypeStateIssuer
0F31162OtherBCN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040129000644 MI Part B Supplier - Clinic/Group Practice 2365345188 Receives reassigned benefits from 2 practitioners
Practice locations: Birmingham, MI

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0362814Dermatology Associates, P C800 S Adams Suite 101, Birmingham, MI 48009Certificate of waiverAug 31, 2027

National Provider Directory

National Provider Directory

Locations

800 S Adams Rd
Birmingham, MI 48009
Phone (248) 646-9597

800 S Adams Rd
Ste 101
Birmingham, MI 48009
Phone (248) 646-9597

Practitioners & affiliated clinicians

Practitioners 5

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": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1871574954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S ADAMS RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097005",
            "telephone_number": "248-646-9597",
            "fax_number": "248-646-4067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S ADAMS RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097005",
            "telephone_number": "248-646-9597",
            "fax_number": "248-646-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "ABBRECHT",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT DERMATOLOGY ASSOCIATES PC",
        "authorized_official_telephone_number": "248-646-9597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "0F31162",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.