Justin Ross Wasserman MD PL

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

ME106806 Issued in FL

Legal business name

JUSTIN ROSS WASSERMAN MD PL

Practice address

409 Serano Way Unit 101
Nokomis, FL 34275-5241

Phone

(941) 484-8222

Fax

(941) 486-3016

NPI assigned

Dec 16, 2010

Last updated

Jun 3, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Ross Wasserman, MDNPI 1043453970

Title

President

Phone

(941) 484-8222

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 4

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.

• Justin Ross Wasserman, MD

  • Dermatology Physician
  • Nokomis, FL
  • NPI 1043453970
  Medicare reassignment NPD Authorized official
• Penelope Kallis Skopis

  • Dermatology Physician
  • Nokomis, FL
  • NPI 1952806531
  Medicare reassignment NPD
• Danielle Lynn Decubellis, ARNP

  • Family Nurse Practitioner
  • Nokomis, FL
  • NPI 1023593142
  NPD
• Olga Ulitsky

  • Dermatology Physician
  • Nokomis, FL
  • NPI 1023284536
  NPD

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1891098612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 SERANO WAY UNIT 101",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342755241",
            "telephone_number": "941-484-8222",
            "fax_number": "941-486-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 SERANO WAY UNIT 101",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342755241",
            "telephone_number": "941-484-8222",
            "fax_number": "941-486-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN ROSS WASSERMAN MD PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "WASSERMAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-484-8222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME106806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan C Jannou
• Jennifer Lynn Jaworski, DMD PA
• Christine Lynn Johnson
• Ciara Johnson, CCC-SLP
• Sara C Johnson
• Dorothy J Kellum, LMT
• Pieter Daniel Kemp, LMT
• Key Pediatric Therapy LLC
• Keystyle Living, LLC (Bayshore Guest Home)
• June R Kirby, LMT

• Clinic/Center in Nokomis, FL
• Providers in Nokomis, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; 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.