Pedram Yazdan, M.D.

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

036120261 Issued in IL

Practice address

1600 N Randall Rd Ste 400
Elgin, IL 60123-7805

Phone

(847) 381-8899

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derick Dermatology PLLCGroup PAC ID 1557366796, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Derick Dermatology, PLLC

  • Dermatology Physician
  • Crystal Lake, IL
  • NPI 1134664402
  Medicare reassignment Care Compare group NPD
• Northwestern Medical Faculty Foundation

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment NPD
• Derick Dermatology, PLLC

  • Dermatology Physician
  • Lindenhurst, IL
  • NPI 1376017038
  NPD
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD
• Derick Dermatology, PLLC

  • Dermatology Physician
  • Tampa, FL
  • NPI 1396455861
  NPD
• Central Dupage Physician Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1982820148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR STE 1000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606118709",
            "telephone_number": "312-695-3988",
            "fax_number": "312-695-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N RANDALL RD STE 400",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237805",
            "telephone_number": "847-381-8899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "676 N Saint Clair St Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112997",
            "country_code": "US",
            "telephone_number": "312-695-3721",
            "fax_number": "312-695-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAZDAN",
        "first_name": "PEDRAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-12-16",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036120261",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036120261",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "IL",
            "license": "036120261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pyazdan@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Derick Dermatology",
            "address_1": "1600 N Randall Rd Ste 400",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601237805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://select.nextech-api.com/api",
            "affiliation": "N",
            "endpointDescription": "Derick Dermatology",
            "address_1": "1600 N Randall Rd Ste 400",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601237805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Selena Caliyan Yang
• Yarkony Rehabilitation Associates LTD
• Gary Michael Yarkony, MD
• Owais Yasin, MD
• Buffy Yatos
• Dina Yazdani
• Santhi Yenna, DDS
• Rajashekar Yerrapragada, M.D.
• Chilakamarri Yeshwant, MD
• Jaclyn Yeung, DO

• Dermatopathology Physician in Elgin, IL
• Providers in Elgin, IL by specialty
• Dermatopathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.