INTEGRATED DERMATOLOGY OF MASS AVE, LLC (NPI# 1417450883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417450883 |
| Entity Type | Organization |
| Organization Name | INTEGRATED DERMATOLOGY OF MASS AVE, LLC |
| Practice Address |
4910 Massachusetts Ave Nw Ste 308 Washington DC 20016-4382 |
| Mailing Address |
4700 Exchange Ct Ste 110 Boca Raton FL 33431-4450 |
| Practice Telephone | 2026951000 |
| Practice Fax Number | 2025031791 |
| Mailing Telephone | 5613142000 |
| Mailing Fax Number | 5614312821 |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-05-01 |
| Authorized Official Name | ADAM S. PLOTKIN (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 5613142000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
4910 MASSACHUSETTS AVE NW STE 308 |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20016-4382 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538554951 | Stephen Suah | Dermatology | 4910 Massachusetts Ave Nw Ste 308, Washington, DC 20016-4382 | 2015-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790390144 | Julie Marcus | Nurse Practitioner | 4200 Wisconsin Avenue Nw, 4th Floor, Washington, DC 20016 | 2020-09-12 |
| 1669080289 | Rachel Mary Lipman | Student in an Organized Health Care Education/Training Program | 5185 Macarthur Blvd, Washington, DC 20016 | 2020-07-20 |
| 1285253484 | Shawn Anthony Haupt | Student in an Organized Health Care Education/Training Program | 4200 Wisconsin Ave, 4th Floor, Dept of Pediatrics, Washington, DC 20016 | 2020-04-09 |
| 1457991176 | Joseph Stephen Driscoll | Specialist/Technologist | St. Albans School / Mount St, Alban, 3001 Wisconsin Ave, Washington, DC 20016 | 2020-01-10 |
| 1164063293 | Christine Ju | Dietitian, Registered | 3517 Ordway St Nw, Washington, DC 20016 | 2019-09-30 |
| 1376191072 | Carlitta Theresa Harris | Registered Nurse | 501 School Street Suite, Suite 200, Sw, DC 20016 | 2019-08-27 |
| 1295399384 | People's Lactation LLC | Registered Nurse | 3022 Wisconsin Ave Nw Apt 208, Washington, DC 20016 | 2019-04-24 |
| 1578057428 | Itzhak Brook | General Practice | 4431 Albemarle St. Nw, Washington, DC 20016 | 2018-06-14 |
| 1093211724 | Hannah Elise Sterling | Student in an Organized Health Care Education/Training Program | 4200 Wisconsin Ave Nw 4th Floor, Department of Pediatrics, Washington, DC 20016 | 2018-04-02 |
| 1447755616 | Michele Elizabeth Zaragoza | Student in an Organized Health Care Education/Training Program | 4200 Wisconsin Ave Nw, 4th Floor, Dept of Pediatrics, Washington, DC 20016 | 2018-03-28 |
| Find all providers in zip 20016 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447410246 | Vishal Anil Patel | Dermatology | 2150 Pennsylvania Ave Nw Ste 2b-430, Washington, DC 20037-3201 | 2008-06-15 |
| 1851312631 | Marisa Ann Braun | Dermatology | 2112 F St Nw, Suite #701, Washington, DC 20037-2715 | 2006-07-21 |
| 1184645988 | Martin Alan Braun | Dermatology | 2112 F St Nw, Suite #701, Washington, DC 20037-2715 | 2006-07-21 |
| 1871510743 | Martin Braun IIi | Dermatology | 2112 F St Nw, Suite #701, Washington, DC 20037-2715 | 2006-07-16 |
| 1285651059 | Martin Braun IIi, M.d., P.C. | Dermatology | 2112 F St Nw, Suite #701, Washington, DC 20037-2715 | 2006-07-16 |
| City | WASHINGTON |
| Zip Code | 20016 |
Please comment or provide details below to improve the information on INTEGRATED DERMATOLOGY OF MASS AVE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.