NPIMap

Organization Active NPI

Derm DX Centers for Dermatology, Inc.

  • Dermatology Physician
  • Hazleton, PA
National Provider Identifier
1992791305
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERM DX CENTERS FOR DERMATOLOGY, INC.
Practice address
20 N Laurel St
Suite 2a
Hazleton, PA 18201-5948
Phone
(570) 459-0029
Fax
(570) 454-5757
NPI assigned
Sep 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen M. Schleicher, M.D.NPI 1861487449
Title
Medical Director
Phone
(570) 459-0029

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

20 N Laurel St
Suite 2a
Hazleton, PA 18201-5948

Mailing address

20 N Laurel St
Suite 2a
Hazleton, PA 18201-5948
Phone (570) 459-0029

Other identifiers 2

IdentifierTypeStateIssuer
347411OtherPABLUE SHIELD
0017950160001MedicaidPA

National Provider Directory

National Provider Directory

Locations

20 N Laurel St
Ste 2A
Hazleton, PA 18201
Phone (570) 459-0029

Practitioners & affiliated clinicians

Practitioners 11

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": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992791305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N LAUREL ST",
            "address_2": "SUITE 2A",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015948",
            "telephone_number": "570-459-0029",
            "fax_number": "570-454-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N LAUREL ST",
            "address_2": "SUITE 2A",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182015948",
            "telephone_number": "570-459-0029",
            "fax_number": "570-454-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERM DX CENTERS FOR DERMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHLEICHER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "570-459-0029",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "347411",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017950160001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.