Organization Active NPI

Dermatology and Dermatologic Surgery LTD

Doing business as Nashville Dermatology Physicians

  • Dermatopathology Physician
  • Brentwood, TN
National Provider Identifier
1871768846
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
2086A0122X Issued in IL
Legal business name
DERMATOLOGY AND DERMATOLOGIC SURGERY LTD
Doing business as
Nashville Dermatology Physicians
Practice address
1001 Health Park Dr Ste 470
Brentwood, TN 37027-5721
Phone
(630) 302-3677
Fax
(630) 302-3677
NPI assigned
Apr 29, 2008
Last updated
Feb 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Authorized official

Name
Jeffrey Berti, MDNPI 1467476457
Title
Medical Director
Phone
(630) 302-3677

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
Dermatopathology Physician 207ND0900X 2086A0122X IL Primary

Addresses

Primary practice location

1001 Health Park Dr Ste 470
Brentwood, TN 37027-5721

Mailing address

1001 Health Park Dr Ste 470
Brentwood, TN 37027-5721
Phone (630) 302-3677

Other names 1

  • Nashville Dermatology Physicians Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240212003723 TN Part B Supplier - Clinic/Group Practice 1052480977 Receives reassigned benefits from 2 practitioners
Practice locations: Brentwood, TN

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
44D2304271Dermatology & Dermatologic Surgery, LTD1001 Health Park Drive, Suite 470, Brentwood, TN 37027ComplianceOct 2, 2026

National Provider Directory

National Provider Directory

Locations

2 Executive Ct
South Barrington, IL 60010
Phone (847) 304-0303

1001 Health Park Dr
Ste 470
Brentwood, TN 37027
Phone (630) 302-3677

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": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1871768846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 HEALTH PARK DR STE 470",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275721",
            "telephone_number": "630-302-3677",
            "fax_number": "630-302-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HEALTH PARK DR STE 470",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275721",
            "telephone_number": "630-302-3677",
            "fax_number": "630-302-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND DERMATOLOGIC SURGERY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "BERTI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "630-302-3677",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "IL",
            "license": "2086A0122X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nashville Dermatology Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brentwood, TN

Sources for this page

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