Organization Active NPI

Consultants in Dermatology, PLLC

  • Dermatology Physician
  • Livonia, MI
National Provider Identifier
1891876538
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CONSULTANTS IN DERMATOLOGY, PLLC
Practice address
20234 Farmington Rd
Livonia, MI 48152-1412
Phone
(248) 474-8440
Fax
(248) 474-5714
NPI assigned
Oct 18, 2006
Last updated
Sep 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Authorized official

Name
Dr. Andrew J Mitchell, MDNPI 1790705044
Title
Member
Phone
(248) 474-8453

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

20234 Farmington Rd
Livonia, MI 48152-1412

Mailing address

20234 Farmington Rd
Livonia, MI 48152-1412
Phone (248) 474-8440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050309000169 MI Part B Supplier - Clinic/Group Practice 1557315942 Receives reassigned benefits from 2 practitioners
Practice locations: Livonia, 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
23D0367922Consultants in Dermatology, PLLC20234 Farmington Road, Livonia, MI 48152Provider-performed microscopyAug 2, 2027

National Provider Directory

National Provider Directory

Locations

20234 Farmington Rd
Livonia, MI 48152
Phone (248) 474-8440

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": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1891876538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20234 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521412",
            "telephone_number": "248-474-8440",
            "fax_number": "248-474-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20234 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521412",
            "telephone_number": "248-474-8440",
            "fax_number": "248-474-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTANTS IN DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "248-474-8453",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.