DERMATOLOGY AT MIDTOWNE, PC
NPI 1780933432
Dermatology in Grand Rapids, MI

Q: What is Dermatology At Midtowne, PC's NPI number?

The NPI number for Dermatology At Midtowne, PC is 1780933432. It was assigned to this organization in the NPPES registry on September 9, 2012.

Q: What is Dermatology At Midtowne, PC's specialty?

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

Active since September 09, 2012CLIA 23D2051558 · Microscopy

555 MIDTOWNE ST NE, SUITE 301, GRAND RAPIDS, MI 49503(616) 248-8864(616) 248-8874 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dermatology At Midtowne, Pc NPPES

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

DERMATOLOGY AT MIDTOWNE, PC (NPI 1780933432) is a healthcare organization registered as a dermatology in Grand Rapids, Michigan and active in the NPI registry since September 2012. The organization holds a CLIA Microscopy certificate valid through March 7, 2027 and lists Dipa Suman Patel, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1780933432

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameDERMATOLOGY AT MIDTOWNE, PC

Location Address555 MIDTOWNE ST NE, SUITE 301Grand Rapids, MI 49503-5729

Mailing Address555 Midtowne St Ne Ste 301Grand Rapids, MI 49503-5729 · (616) 248-8864 · Fax (616) 248-8874

Phone(616) 248-8864

Fax(616) 248-8874

Organization SubpartNo

Authorized OfficialDipa Suman PatelPhysician/owner · (616) 248-8864

Enumeration DateSeptember 9, 2012

Last NPPES UpdateMarch 18, 2024

NPPES CertifiedMarch 18, 2024

✔ NPI 1780933432 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.

555 MIDTOWNE ST NE, Grand Rapids, MI 49503

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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 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 At Midtowne, 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 Dermatology At Midtowne, PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dipa Patel, MD

Dermatology

NPI 1205836962

555 MIDTOWNE ST NE SUITE 301
Grand Rapids, MI 49503

(616) 248-8864

✔ PECOS✔ Accepts MedicareSame address

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) 23D2051558

Dermatology At Midtowne, PC · Grand Rapids, MI

Active · expires Mar 7, 2027

CLIA Number23D2051558

Laboratory TypePhysician Office

Certificate Effective DateMarch 8, 2025

Certificate Expiration DateMarch 7, 2027

Laboratory DirectorDipa S. Patel

Laboratory Phone(616) 248-8864

Laboratory LocationDermatology At Midtowne, PC555 Midtowne St NE, Suite 301, Grand Rapids, MI 49503

CLIA data matches this NPI record on: Address Name 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 At Midtowne, PC's NPI number?

The NPI number for Dermatology At Midtowne, PC is 1780933432. It was assigned to this organization in the NPPES registry on September 9, 2012.

Where is Dermatology At Midtowne, PC located?

Dermatology At Midtowne, PC is located at 555 Midtowne St NE Suite 301, Grand Rapids, MI 49503. The listed phone number is (616) 248-8864.

What is Dermatology At Midtowne, PC's specialty?

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

Is Dermatology At Midtowne, PC enrolled in Medicare?

Yes. Dermatology At Midtowne, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology At Midtowne, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Dermatology At Midtowne, 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 Dermatology At Midtowne, PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D2051558) is associated with this NPI, valid through March 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dermatology At Midtowne, PC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Dermatology At Midtowne, 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 At Midtowne, PC was last updated on March 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.