Organization Active NPI

Dermatology Consultants of Northern Jersey LLC

  • Dermatology Physician
  • Morristown, NJ
National Provider Identifier
1942201645
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
57078 Issued in NJ
Legal business name
DERMATOLOGY CONSULTANTS OF NORTHERN JERSEY LLC
Practice address
261 James St
Suite 2B
Morristown, NJ 07960-6392
Phone
(973) 993-1433
Fax
(973) 993-1176
NPI assigned
Aug 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Authorized official

Name
Mark Popkin, MDNPI 1225026834
Title
Medical Doctor
Phone
(973) 993-1433

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 57078 NJ Primary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 57081 NJ

Addresses

Primary practice location

261 James St
Suite 2B
Morristown, NJ 07960-6392

Mailing address

261 James St
Suite 2B
Morristown, NJ 07960-6392
Phone (973) 993-1433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050331000865 NJ Part B Supplier - Clinic/Group Practice 8224085311 Receives reassigned benefits from 2 practitioners
Practice locations: Morristown, NJ

National Provider Directory

National Provider Directory

Locations

261 James St
Ste 2B
Morristown, NJ 07960
Phone (973) 993-1433

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360886400000",
    "number": "1942201645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 JAMES ST",
            "address_2": "SUITE 2B",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606392",
            "telephone_number": "973-993-1433",
            "fax_number": "973-993-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 JAMES ST",
            "address_2": "SUITE 2B",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606392",
            "telephone_number": "973-993-1433",
            "fax_number": "973-993-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CONSULTANTS OF NORTHERN JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2013-02-15",
        "status": "A",
        "authorized_official_last_name": "POPKIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "973-993-1433",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "57078",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "57081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.