INTEGRATED DERMATOLOGY OF MASS AVE, LLC
NPI 1417450883
Dermatology - MOHS-Micrographic Surgery in Washington, DC

Q: What is Integrated Dermatology Of Mass Ave, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Active since March 13, 2018

4910 MASSACHUSETTS AVE NW STE 308, WASHINGTON, DC 20016(202) 695-1000(202) 503-1791 Get Directions Write a Review

NPPES record last updated: May 1, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 1, 2018, Mar 13, 2018 (2 updates tracked since 2018).

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About Integrated Dermatology Of Mass Ave, Llc NPPES

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

INTEGRATED DERMATOLOGY OF MASS AVE, LLC (NPI 1417450883) is a healthcare organization registered as a mohs-micrographic surgery in Washington, District Of Columbia and active in the NPI registry since March 2018. The organization lists Adam S. Plotkin, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1417450883

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameINTEGRATED DERMATOLOGY OF MASS AVE, LLC

Location Address4910 MASSACHUSETTS AVE NW STE 308Washington, DC 20016-4382

Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000 · Fax (561) 431-2821

Phone(202) 695-1000

Fax(202) 503-1791

Organization SubpartNo

Authorized OfficialAdam S. PlotkinAuthorized Official · (561) 314-2000

Enumeration DateMarch 13, 2018

Last NPPES UpdateMay 1, 20182 updates tracked since enumeration

✔ NPI 1417450883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

Definition

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.

4910 MASSACHUSETTS AVE NW STE 308, Washington, DC 20016

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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 MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Integrated Dermatology Of Mass Ave, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Integrated Dermatology Of Mass Ave, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Wallace Nozile, MD

Dermatology

NPI 1093101107

4910 MASSACHUSETTS AVE NW STE 308
Washington, DC 20016

(202) 695-1000

✔ PECOS✔ Accepts MedicareSame address

Stephen Suah, M.D.

Dermatology

NPI 1538554951

4910 MASSACHUSETTS AVE NW STE 308
Washington, DC 20016

(202) 695-1000

✔ PECOS✔ Accepts MedicareSame address

Todd Perkins, MD

Dermatology

NPI 1982641148

900 17TH ST NW STE 300
Washington, DC 20006

(202) 659-2223

✔ PECOS✔ Accepts Medicare4.4 mi

Raina Bembry, MD

Dermatology

NPI 1942769724

10680 MAIN ST STE 200
Fairfax, VA 22030

(703) 352-2620

✔ PECOS✔ Accepts Medicare13 mi

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

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 Integrated Dermatology Of Mass Ave, LLC's NPI number?

The NPI number for Integrated Dermatology Of Mass Ave, LLC is 1417450883. It was assigned to this organization in the NPPES registry on March 13, 2018.

Where is Integrated Dermatology Of Mass Ave, LLC located?

Integrated Dermatology Of Mass Ave, LLC is located at 4910 Massachusetts Ave NW Ste 308, Washington, DC 20016. The listed phone number is (202) 695-1000.

What is Integrated Dermatology Of Mass Ave, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Integrated Dermatology Of Mass Ave, LLC enrolled in Medicare?

Yes. Integrated Dermatology Of Mass Ave, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Integrated Dermatology Of Mass Ave, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Dermatology, reassign their Medicare billing to Integrated Dermatology Of Mass Ave, LLC. 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. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Integrated Dermatology Of Mass Ave, LLC was last updated on May 1, 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.