Dermatology Institute and Skin Cancer Center LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY INSTITUTE AND SKIN CANCER CENTER LLC

Practice address

2783 Brownwood Blvd
The Villages, FL 32163

Phone

(352) 834-7546

NPI assigned

May 29, 2020

Last updated

Mar 21, 2021By 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

Charles Knapp, MDNPI 1023246527

Title

Co-Owner

Phone

(352) 834-7546

Specialties & licenses 1

Addresses

Other names 1

• The Dermatology Institute and Skin Cancer Center Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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.

• Charles F Knapp III, MD

  • MOHS-Micrographic Surgery Physician
  • The Villages, FL
  • NPI 1023246527

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Brandon Max Markus, D.O.

  • Dermatology Physician
  • The Villages, FL
  • NPI 1134440365
  Medicare reassignment Care Compare group NPD
• Jason Sirel, APRN

  • Gerontology Nurse Practitioner
  • Lecanto, FL
  • NPI 1114643152
  Medicare reassignment NPD
• Heather M Gates, PA-C

  • Physician Assistant
  • The Villages, FL
  • NPI 1366726986
  Medicare reassignment

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616284800000",
    "number": "1891319422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2783 BROWNWOOD BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321632005",
            "telephone_number": "352-834-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2783 BROWNWOOD BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "32163",
            "telephone_number": "352-834-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY INSTITUTE AND SKIN CANCER CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-21",
        "status": "A",
        "authorized_official_last_name": "KNAPP",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "352-834-7546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dermatology Institute and Skin Cancer Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Dermatology Institute and Skin Cancer Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madelyn Delgado Borges, APRN
• Neutt Dellareeda, MSN, APRN, FNP-BC
• Ryan A Demello
• Sarah Denion
• Carolyne B. Denonno, CL,ASCP,COE
• Laura Erika Dermenjian, PA
• Derrick J Martin MD PA
• Prashant Arun Desai, M.D.
• Emily Descano, AUD
• Anthony John Desmarais II, D.O.

• Dermatology Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.