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PSORIASIS AND ECZEMA TREATMENT CENTER OF WESTERN MICHIGAN PLLC
NPI 1396745055
Dermatology in Grand Rapids, MI

Active since July 26, 2005CLIA 23D0694147 · Certificate of Compliance
833 MICHIGAN ST NE, SUITE 102, GRAND RAPIDS, MI 49503(616) 459-8209(616) 459-0313 Get Directions Write a Review

NPPES record last updated: March 22, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Psoriasis And Eczema Treatment Center Of Western Michigan Pllc NPPES

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

PSORIASIS AND ECZEMA TREATMENT CENTER OF WESTERN MICHIGAN PLLC (NPI 1396745055) is a healthcare organization registered as a dermatology in Grand Rapids, Michigan and active in the NPI registry since July 2005. The organization holds a CLIA Certificate of Compliance certificate valid through May 16, 2027, maintains a secondary practice location in Jenison, and lists Marek A Stawiski, Physician, as its authorized official.

NPPES Registry Identity

NPI1396745055
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePSORIASIS AND ECZEMA TREATMENT CENTER OF WESTERN MICHIGAN PLLC
Location Address833 MICHIGAN ST NE, SUITE 102Grand Rapids, MI 49503-3523
Mailing Address833 Michigan St Ne, Suite 102Grand Rapids, MI 49503-3523 · (616) 459-8209 · Fax (616) 459-0313
Phone(616) 459-8209
Fax(616) 459-0313
Organization SubpartNo
Authorized OfficialMarek A StawiskiPhysician · (616) 459-8209
Enumeration DateJuly 26, 2005
Last NPPES UpdateMarch 22, 2018
✔ NPI 1396745055 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.
833 MICHIGAN ST NE, Grand Rapids, MI 49503
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Secondary Practice Location 1

Location 1597 Baldwin StJenison, MI 49428-7994 · Phone (616) 457-4251 · Fax (616) 457-8410

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 Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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 23D0694147

Psoriasis And Eczema Tx Center Of Western Mi · Jenison, MI
Active · expires May 16, 2027
CLIA Number23D0694147
Laboratory TypePhysician Office
Certificate Effective DateMay 17, 2025
Certificate Expiration DateMay 16, 2027
Laboratory DirectorMarek A. Stawiski
Laboratory Phone(616) 459-8209
Laboratory LocationPsoriasis And Eczema Tx Center Of Western Mi597 Baldwin St, Jenison, MI 49428
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARY ANN YURKO MD
Dermatology
833 MICHIGAN ST NE, SUITE 102
GRAND RAPIDS, MI 49503
Kent County (616) 459-1440
RICHARD HUGH BENNINGER MD
Ophthalmology
833 MICHIGAN ST NE, SUITE 101
GRAND RAPIDS, MI 49503
Kent County (616) 459-3713
MR. MATTHEW T ZOETEMAN PA-C
Physician Assistant
833 MICHIGAN ST NE, SUITE 102
GRAND RAPIDS, MI 49503
Kent County (616) 459-8209
DR. JOHN R. VYDARENY MD
Dermatology
833 MICHIGAN ST NE, SUITE 102
GRAND RAPIDS, MI 49503
Kent County (616) 459-1144
MARY A YURKO MD DERMATOLOGY PLC
Dermatology
833 MICHIGAN ST NE, SUITE 102
GRAND RAPIDS, MI 49503
Kent County (616) 459-1440
MR. MAREK A STAWISKI MD
Dermatology (Dermatopathology)
833 MICHIGAN ST NE, SUITE 102
GRAND RAPIDS, MI 49503
Kent County (616) 459-8209

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 Psoriasis And Eczema Treatment Center Of Western Michigan PLLC's NPI number?

The NPI number for Psoriasis And Eczema Treatment Center Of Western Michigan PLLC is 1396745055. It was assigned to this organization in the NPPES registry on July 26, 2005.

Where is Psoriasis And Eczema Treatment Center Of Western Michigan PLLC located?

Psoriasis And Eczema Treatment Center Of Western Michigan PLLC is located at 833 Michigan St NE Suite 102, Grand Rapids, MI 49503. The listed phone number is (616) 459-8209.

What is Psoriasis And Eczema Treatment Center Of Western Michigan PLLC's specialty?

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

Does Psoriasis And Eczema Treatment Center Of Western Michigan PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 23D0694147) is associated with this NPI, valid through May 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Psoriasis And Eczema Treatment Center Of Western Michigan PLLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Psoriasis And Eczema Treatment Center Of Western Michigan 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 Psoriasis And Eczema Treatment Center Of Western Michigan PLLC was last updated on March 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.