NPIMap

Organization Active NPI

Forefront Dermatology, S.C.

Doing business as dba Advanced Dermatology, A Forefront Dermatology Practice

  • Dermatology Physician
  • League City, TX
National Provider Identifier
1912724188
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
FOREFRONT DERMATOLOGY, S.C.
Doing business as
dba Advanced Dermatology, A Forefront Dermatology Practice
Practice address
1615 W League City Pkwy Ste 300
League City, TX 77573-7458
Phone
(281) 665-4444
Fax
(281) 325-5374
NPI assigned
Sep 20, 2024
Last updated
Sep 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Authorized official

Name
Dr. Betsy J Wernli, MDNPI 1437378973
Title
President
Phone
(920) 482-0671

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary
MOHS-Micrographic Surgery Physician 207ND0101X
Procedural Dermatology Physician 207NS0135X

Addresses

Primary practice location

1615 W League City Pkwy Ste 300
League City, TX 77573-7458

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other names 1

  • dba Advanced Dermatology, A Forefront Dermatology Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220629000019 TX Part B Supplier - Clinic/Group Practice 3779471701 Receives reassigned benefits from 26 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pearland, TX; Sugar Land, TX; Southlake, TX; League City, TX; Houston, TX; Dallas, TX

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1912724188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 W LEAGUE CITY PKWY STE 300",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775737458",
            "telephone_number": "281-665-4444",
            "fax_number": "281-325-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "WERNLI",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-482-0671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Advanced Dermatology, A Forefront Dermatology Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.