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LAKE MICHIGAN DERMATOLOGY PLLC
NPI 1235863978
Dermatology in Holland, MI

Active since July 10, 2022CLIA 23D2276065 · Certificate of Compliance
1148 WASHINGTON AVE STE 20, HOLLAND, MI 49423(616) 499-4844(616) 499-4847 Get Directions Write a Review

NPPES record last updated: March 13, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 13, 2023, Jul 10, 2022 (2 updates tracked since 2022).

About Lake Michigan Dermatology Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE MICHIGAN DERMATOLOGY PLLC (NPI 1235863978) is a healthcare organization registered as a dermatology in Holland, Michigan and active in the NPI registry since July 2022. The organization holds a CLIA Certificate of Compliance certificate valid through November 7, 2027 and lists Anthony Berger, Manager, Owner, as its authorized official.

NPPES Registry Identity

NPI1235863978
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameLAKE MICHIGAN DERMATOLOGY PLLC
Location Address1148 WASHINGTON AVE STE 20Holland, MI 49423-7728
Mailing Address1148 Washington Ave Ste 20Holland, MI 49423-7728 · (616) 499-4844 · Fax (269) 849-8708
Phone(616) 499-4844
Fax(616) 499-4847
Organization SubpartNo
Authorized OfficialAnthony BergerManager, Owner · (616) 499-4844
Enumeration DateJuly 10, 2022
Last NPPES UpdateMarch 13, 20232 updates tracked since enumeration
NPPES CertifiedMarch 13, 2023
✔ NPI 1235863978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1148 WASHINGTON AVE STE 20, Holland, MI 49423
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lake Michigan Dermatology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lake Michigan Dermatology PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Anthony Berger, MD
Dermatology
NPI 1508391160
1148 WASHINGTON AVE STE 20
Holland, MI 49423
(616) 499-4844
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 23D2276065

Lake Michigan Dermatology PLLC · Holland, MI
Active · expires Nov 7, 2027
CLIA Number23D2276065
Laboratory TypePhysician Office
Certificate Effective DateNovember 8, 2025
Certificate Expiration DateNovember 7, 2027
Laboratory DirectorAnthony P. Berger
Laboratory Phone(616) 499-4844
Laboratory LocationLake Michigan Dermatology PLLC1148 Washington Ave Ste 20, Holland, MI 49423
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Michigan Dermatology PLLC's NPI number?

The NPI number for Lake Michigan Dermatology PLLC is 1235863978. It was assigned to this organization in the NPPES registry on July 10, 2022.

Where is Lake Michigan Dermatology PLLC located?

Lake Michigan Dermatology PLLC is located at 1148 Washington Ave Ste 20, Holland, MI 49423. The listed phone number is (616) 499-4844.

What is Lake Michigan Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Lake Michigan Dermatology PLLC enrolled in Medicare?

Yes. Lake Michigan Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lake Michigan Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Lake Michigan Dermatology PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lake Michigan Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 23D2276065) is associated with this NPI, valid through November 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lake Michigan Dermatology PLLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lake Michigan Dermatology PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Michigan Dermatology PLLC was last updated on March 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.