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LAKESHORE DERM & LASER CENTER PLC
NPI 1538209945
Dermatology - Procedural Dermatology in Norton Shores, MI

Active since February 07, 2007
6225 PRAIRIE ST, NORTON SHORES, MI 49444(231) 798-9500(231) 798-9533 Get Directions Write a Review

NPPES record last updated: October 22, 2013. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Lakeshore Derm & Laser Center Plc NPPES

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

LAKESHORE DERM & LASER CENTER PLC (NPI 1538209945) is a healthcare organization registered as a procedural dermatology in Norton Shores, Michigan and active in the NPI registry since February 2007. The organization lists Jason Barrett Van Ittersum, Owner, as its authorized official.

NPPES Registry Identity

NPI1538209945
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameLAKESHORE DERM & LASER CENTER PLC
Location Address6225 PRAIRIE STNorton Shores, MI 49444-7831
Mailing Address6225 Prairie StNorton Shores, MI 49444-7831 · (231) 798-9500 · Fax (231) 798-9533
Phone(231) 798-9500
Fax(231) 798-9533
Organization SubpartNo
Authorized OfficialJason Barrett Van IttersumOwner · (231) 798-9500
Enumeration DateFebruary 7, 2007
Last NPPES UpdateOctober 22, 2013
✔ NPI 1538209945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
6225 PRAIRIE ST, Norton Shores, MI 49444
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Other Identifiers 1

Medicare ID-Type Unspecified0P29750MI · Medicare Group

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.Insurance ›

Other Providers at the Same Location NPPES 7

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

FOREFRONT DERMATOLOGY, S.C.
Dermatology
6225 PRAIRIE ST
NORTON SHORES, MI 49444
Muskegon County (231) 798-9500
LEAH E LILLMARS PA
Physician Assistant
6225 PRAIRIE ST
NORTON SHORES, MI 49444
Muskegon County (231) 798-9500
TIMOTHY S WANG MD
Dermatology
6225 PRAIRIE ST
NORTON SHORES, MI 49444
Muskegon County (231) 798-9500
JULIE MAIRE MURRAY DULL PA-C
Physician Assistant (Medical)
6225 PRAIRIE ST
NORTON SHORES, MI 49444
Muskegon County (231) 798-9500
DR. JASON BARRETT VAN ITTERSUM M.D.
Dermatology
6225 PRAIRIE ST
NORTON SHORES, MI 49444
Muskegon County (231) 798-9500
MADISON ANNE ELDRED PA
Physician Assistant
6225 PRAIRIE ST
NORTON SHORES, MI 49444
Muskegon County (231) 798-9500
ROBERT A GIELCZYK MD
Dermatology
6225 PRAIRIE ST
NORTON SHORES, MI 49444
Muskegon County (231) 798-9500

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 Lakeshore Derm & Laser Center Plc's NPI number?

The NPI number for Lakeshore Derm & Laser Center Plc is 1538209945. It was assigned to this organization in the NPPES registry on February 7, 2007.

Where is Lakeshore Derm & Laser Center Plc located?

Lakeshore Derm & Laser Center Plc is located at 6225 Prairie St, Norton Shores, MI 49444. The listed phone number is (231) 798-9500.

What is Lakeshore Derm & Laser Center Plc's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

What insurance does Lakeshore Derm & Laser Center Plc accept?

Health plans from Blue Care Network of Michigan list Lakeshore Derm & Laser Center Plc 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 Lakeshore Derm & Laser Center Plc was last updated on October 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.