Organization Active NPI

Advanced Dermatology Associates, P.a.

  • Dermatology Physician
  • West Orange, NJ
National Provider Identifier
1871638940
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ADVANCED DERMATOLOGY ASSOCIATES, P.A.
Practice address
101 Old Short Hills Rd Ste 205
West Orange, NJ 07052-1093
Phone
(973) 243-2300
Fax
(973) 243-2400
NPI assigned
Feb 20, 2007
Last updated
Nov 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Authorized official

Name
Dr. Cheryl Citron, MDNPI 1235168386
Title
Owner
Phone
(972) 535-3200

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

101 Old Short Hills Rd Ste 205
West Orange, NJ 07052-1093

Mailing address

315 E Northfield Rd
2A
Livingston, NJ 07039-4896
Phone (973) 535-3200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110405000124 NJ Part B Supplier - Clinic/Group Practice 4385828003 Receives reassigned benefits from 5 practitioners
Practice locations: West Orange, NJ

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
31D2331069Advanced Dermatology Associates101 Old Short Hills Rd, West Orange, NJ 07052RegistrationSep 24, 2027

National Provider Directory

National Provider Directory

Locations

1907 Wayzata Blvd
Ste 350
Wayzata, MN 55391
Phone (952) 989-1600

101 Old Short Hills Rd
Ste 205
West Orange, NJ 07052
Phone (973) 243-2300

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1871638940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E NORTHFIELD RD",
            "address_2": "2A",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394896",
            "telephone_number": "973-535-3200",
            "fax_number": "973-535-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD STE 205",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521093",
            "telephone_number": "973-243-2300",
            "fax_number": "973-243-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "CITRON",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-535-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.