NPIMap

Organization Active NPI

Dermacare Senior Solutions LLC

  • Nurse Practitioner
  • Lake Mary, FL
National Provider Identifier
1972391357
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
DERMACARE SENIOR SOLUTIONS LLC
Practice address
731 Stirling Center PL Unit 1931
Lake Mary, FL 32746-5209
Phone
(386) 523-8345
NPI assigned
Apr 28, 2025
Last updated
Apr 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Authorized official

Name
Mr. Alexander Terentev
Title
Chief Executive Officer
Phone
(386) 523-8345

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

731 Stirling Center PL Unit 1931
Lake Mary, FL 32746-5209

Mailing address

782 Lake Como Dr
Lake Mary, FL 32746-4811
Phone (386) 523-8345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250825002397 FL Part B Supplier - Clinic/Group Practice 7113427006 Receives reassigned benefits from 10 practitioners
Practice locations: Lake Mary, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1745798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1972391357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "782 LAKE COMO DR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327464811",
            "telephone_number": "386-523-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 STIRLING CENTER PL UNIT 1931",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465209",
            "telephone_number": "386-523-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMACARE SENIOR SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A",
        "authorized_official_last_name": "TERENTEV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "386-523-8345",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.