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DERMATOLOGY ASSOC OF MACOMB OAKLAND PC
NPI 1417058116
Specialist in Warren, MI

Active since September 26, 2006CLIA 23D0366029 · Microscopy
11250 E 13 MILE RD, STE 2B, WARREN, MI 48093(586) 751-2520(586) 751-7004 Get Directions Write a Review

NPPES record last updated: May 29, 2013. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dermatology Assoc Of Macomb Oakland Pc NPPES

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

DERMATOLOGY ASSOC OF MACOMB OAKLAND PC (NPI 1417058116) is a healthcare organization registered as a specialist in Warren, Michigan and active in the NPI registry since September 2006. The organization holds a CLIA Microscopy certificate valid through February 10, 2028 and lists Joseph William Kaufman, President, as its authorized official.

NPPES Registry Identity

NPI1417058116
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameDERMATOLOGY ASSOC OF MACOMB OAKLAND PC
Location Address11250 E 13 MILE RD, STE 2BWarren, MI 48093-2597
Mailing Address11250 E 13 Mile Rd, Ste 2bWarren, MI 48093-2597 · (586) 751-2520 · Fax (586) 751-7004
Phone(586) 751-2520
Fax(586) 751-7004
Organization SubpartNo
Authorized OfficialJoseph William KaufmanPresident · (586) 751-2520
Enumeration DateSeptember 26, 2006
Last NPPES UpdateMay 29, 2013
✔ NPI 1417058116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
11250 E 13 MILE RD, Warren, MI 48093
Open in Google Maps ↗

Other Identifiers 2

Other070E060680MI · Bcbsm
Medicare ID-Type Unspecified0E06068MI

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)

Dermatology Assoc Of Macomb Oakland Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Dermatology Assoc Of Macomb Oakland PC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (6)

Mark Harbeck, M.D.
Dermatology
NPI 1578665527
26850 PROVIDENCE PKWY STE 535
Novi, MI 48374
(248) 380-8900
✔ PECOS✔ Accepts Medicare11 mi
Ayad Abrou, M.D.
Dermatology
NPI 1457305815
110 SOUTH BLVD W STE 100
Rochester Hills, MI 48307
(248) 852-1900
✔ PECOS✔ Accepts Medicare18 mi
Daniela Maxim, FNP-BC
Nurse Practitioner
NPI 1962892307
255 KIRTS BLVD SUITE 100
Troy, MI 48084
(248) 244-8448
✔ PECOS✔ Accepts Medicare18 mi
Jane Kim, M.D.
Dermatology
NPI 1306947171
11250 E 13 MILE RD STE 2B
Warren, MI 48093
(586) 751-2520
✔ PECOS✔ Accepts Medicare25 mi
Louise Martin, M.D.
Dermatology
NPI 1871680124
11250 E 13 MILE RD STE 2B
Warren, MI 48093
(586) 751-2520
✔ PECOS✔ Accepts Medicare25 mi
Douglas Laurain
Dermatology
NPI 1467870956
2799 W GRAND BLVD 2799 W. GRAND BOULEVARD
Detroit, MI 48202
(313) 916-2600
✔ PECOS✔ Accepts Medicare28 mi

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 for Provider-Performed Microscopy Procedures (PPMP) 23D0366029

Dermatology Associates Of Macomb Oakland PC · Warren, MI
Active · expires Feb 10, 2028
CLIA Number23D0366029
Laboratory TypePhysician Office
Certificate Effective DateFebruary 11, 2026
Certificate Expiration DateFebruary 10, 2028
Laboratory DirectorDouglas A. Laurain
Laboratory Phone(586) 751-2520
Laboratory LocationDermatology Associates Of Macomb Oakland PC11250 E 13 Mile Road Suite 2B, Warren, MI 48093
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Dermatology Assoc Of Macomb Oakland PC's NPI number?

The NPI number for Dermatology Assoc Of Macomb Oakland PC is 1417058116. It was assigned to this organization in the NPPES registry on September 26, 2006.

Where is Dermatology Assoc Of Macomb Oakland PC located?

Dermatology Assoc Of Macomb Oakland PC is located at 11250 E 13 Mile Rd Ste 2B, Warren, MI 48093. The listed phone number is (586) 751-2520.

What is Dermatology Assoc Of Macomb Oakland PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Dermatology Assoc Of Macomb Oakland PC enrolled in Medicare?

Yes. Dermatology Assoc Of Macomb Oakland PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology Assoc Of Macomb Oakland PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Dermatology Assoc Of Macomb Oakland PC. 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. The largest specialties are Dermatology (5) and Nurse Practitioner (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dermatology Assoc Of Macomb Oakland PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0366029) is associated with this NPI, valid through February 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dermatology Assoc Of Macomb Oakland PC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Dermatology Assoc Of Macomb Oakland PC 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 Dermatology Assoc Of Macomb Oakland PC was last updated on May 29, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.