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PHILADELPHIA CENTER FOR DERMATOLOGY, PC
NPI 1598176554
Dermatology - Dermatopathology in Philadelphia, PA

Active since May 13, 2014CLIA 39D2087795 · Certificate of Compliance
8400 ROOSEVELT BLVD, SUITE 200, PHILADELPHIA, PA 19152(267) 538-5045(267) 538-2153 Get Directions Write a Review

NPPES record last updated: August 22, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Philadelphia Center For Dermatology, Pc NPPES

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

PHILADELPHIA CENTER FOR DERMATOLOGY, PC (NPI 1598176554) is a healthcare organization registered as a dermatopathology in Philadelphia, Pennsylvania and active in the NPI registry since May 2014. The organization holds a CLIA Certificate of Compliance certificate valid through May 18, 2027 and lists Atsuko Kodama, Owner, as its authorized official.

NPPES Registry Identity

NPI1598176554
Entity TypeOrganization
Primary Taxonomy207ND0900X
Legal Business NamePHILADELPHIA CENTER FOR DERMATOLOGY, PC
Location Address8400 ROOSEVELT BLVD, SUITE 200Philadelphia, PA 19152-2081
Mailing Address8400 Roosevelt Blvd, Suite 200Philadelphia, PA 19152-2081 · (267) 538-5045 · Fax (267) 538-2153
Phone(267) 538-5045
Fax(267) 538-2153
Organization SubpartNo
Authorized OfficialAtsuko KodamaOwner · (267) 538-5045
Enumeration DateMay 13, 2014
Last NPPES UpdateAugust 22, 2014
✔ NPI 1598176554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatology · DermatopathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ND0900X
License✔ Licensed in PA · MD440883
Definition
A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License MD440883 (PA)
8400 ROOSEVELT BLVD, Philadelphia, PA 19152
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Other Identifiers 1

Medicare PIN357429PA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Philadelphia Center For Dermatology, Pc 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 Philadelphia Center For Dermatology, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Atsuko Kodama, MD, PHD
Dermatology
NPI 1699976340
361 HIGHLAND AVE STE 204
Jenkintown, PA 19046
(267) 538-5045
✔ PECOS✔ Accepts Medicare5.7 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 of Compliance 39D2087795

Philadelphia Center For Dermatology · Jenkintown, PA
Active · expires May 18, 2027
CLIA Number39D2087795
Laboratory TypePhysician Office
Certificate Effective DateMay 19, 2025
Certificate Expiration DateMay 18, 2027
Laboratory DirectorDr. Atsuko Kodama
Laboratory Phone(267) 538-5045
Laboratory LocationPhiladelphia Center For Dermatology361 Highland Ave, Suite 204, Jenkintown, PA 19046
CLIA data matches this NPI record on: 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 Philadelphia Center For Dermatology, PC's NPI number?

The NPI number for Philadelphia Center For Dermatology, PC is 1598176554. It was assigned to this organization in the NPPES registry on May 13, 2014.

Where is Philadelphia Center For Dermatology, PC located?

Philadelphia Center For Dermatology, PC is located at 8400 Roosevelt Blvd Suite 200, Philadelphia, PA 19152. The listed phone number is (267) 538-5045.

What is Philadelphia Center For Dermatology, PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Dermatopathology, with taxonomy code 207ND0900X.

Is Philadelphia Center For Dermatology, PC enrolled in Medicare?

Yes. Philadelphia Center For Dermatology, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Philadelphia Center For Dermatology, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Philadelphia Center For Dermatology, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Philadelphia Center For Dermatology, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 39D2087795) is associated with this NPI, valid through May 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Philadelphia Center For Dermatology, PC was last updated on August 22, 2014. 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.