1. Home
  2. Directory
  3. Ohio
  4. Boardman
  5. Dermatology
  6. NPI Profile

OPTIMA DERMATOLOGY LLC
NPI 1831187764
Dermatology in Boardman, OH

Active since October 13, 2005CLIA Certified · 5 labs
987 BOARDMAN CANFIELD RD, BOARDMAN, OH 44512(330) 965-8760(330) 965-9325 Get Directions Write a Review

NPPES record last updated: July 1, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 1, 2024, May 10, 2024, Nov 3, 2023 and 7 more (10 updates tracked since 2021).

About Optima Dermatology Llc NPPES

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

OPTIMA DERMATOLOGY LLC (NPI 1831187764), doing business as Advanced Dermatology And Skin Cancer Center Llc, is a healthcare organization registered as a dermatology in Boardman, Ohio and active in the NPI registry since October 2005. The organization holds 5 active CLIA laboratory certificates, maintains 20 additional practice locations, and lists John Bernat, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1831187764
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameOPTIMA DERMATOLOGY LLC
Location Address987 BOARDMAN CANFIELD RDBoardman, OH 44512-4222
Mailing Address111 New Hampshire Ave Ste 2Portsmouth, NH 03801-2864 · (802) 909-2053 · Fax (330) 965-9325
Phone(330) 965-8760
Fax(330) 965-9325
Organization SubpartNo
Authorized OfficialJohn BernatAuthorized Official · (330) 965-8760
Enumeration DateOctober 13, 2005
Last NPPES UpdateJuly 1, 202410 updates tracked since enumeration
NPPES CertifiedJuly 1, 2024
✔ NPI 1831187764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ 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.
Also ListedSpecialistTaxonomy 174400000X
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
Also ListedPathology · Anatomic PathologyTaxonomy 207ZP0101X
987 BOARDMAN CANFIELD RD, Boardman, OH 44512
Open in Google Maps ↗

Other Names 1

Former Legal Business NameAdvanced Dermatology And Skin Cancer Center Llc

Secondary Practice Locations 20

Location 11 Hampton Rd Unit A306Exeter, NH 03833-4848 · Phone (603) 942-2171 · Fax (603) 371-3104
Location 271 US Route 1 Ste JScarborough, ME 04074-7168 · Phone (207) 464-2712
Location 331 Stiles Rd Ste 2100Salem, NH 03079-3035 · Phone (603) 942-2020 · Fax (603) 288-1722
Location 45817 Happy Hollow RdMilford, OH 45150-1848 · Phone (513) 327-9244 · Fax (513) 323-5201
Location 52223 Niles Cortland Rd SEWarren, OH 44484-3043 · Phone (330) 965-8760 · Fax (330) 469-9706
Location 68183 Golden Link BlvdMacedonia, OH 44067 · Phone (330) 778-1278
Location 7321 Niles Cortland Rd NE # UnitebWarren, OH 44484-1974 · Phone (330) 800-5963 · Fax (330) 469-9706
Location 82525 E State StSalem, OH 44460-9303 · Phone (330) 271-8614 · Fax (330) 525-9008
Location 9111 New Hampshire Ave Ste 3Portsmouth, NH 03801-2864 · Phone (603) 988-0951
Location 107676 Reynolds RdMentor, OH 44060-5110 · Phone (440) 283-3015 · Fax (440) 283-3010
Location 111039 Boardman Canfield RdBoardman, OH 44512-4228 · Phone (330) 271-8589 · Fax (330) 965-9325
Location 121027 Boardman Canfield RdBoardman, OH 44512-4227 · Phone (330) 965-8760 · Fax (330) 965-9325
Location 13911 E Aurora RdMacedonia, OH 44056-1905 · Phone (330) 306-9844 · Fax (330) 525-9009
Location 141100 Southfield Dr Ste 1240Plainfield, IN 46168-4499 · Phone (317) 838-9911 · Fax (317) 837-6080
Location 15824 Edwards DrPlainfield, IN 46168-2791 · Phone (317) 406-3254 · Fax (317) 406-3259
Location 161010 W 2nd StBloomington, IN 47403-2217 · Phone (812) 200-2458 · Fax (930) 200-8590
Location 172800 S State Road 135 Ste 250Greenwood, IN 46143-6223 · Phone (317) 300-1788 · Fax (317) 743-8103
Location 186639 Whitestown PkwyZionsville, IN 46077-7622 · Phone (317) 732-8980 · Fax (317) 732-8979
Location 1929 Sebago RdRaymond, ME 04071-6823 · Phone (207) 838-9073 · Fax (207) 203-4875
Location 20215 Commerce Way Ste 100Portsmouth, NH 03801-3244 · Phone (603) 441-1075 · Fax (603) 294-1090

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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 Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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)

Optima Dermatology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

57

Medicare enrollment records show 57 clinicians reassign Medicare billing to Optima Dermatology LLC, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Dermatology31
Nurse Practitioner19
Pathology4
Micrographic Dermatologic Surgery (MDS)3

Nearest to this location (20)

See all 57
Mariel Bird, D.O.
Dermatology
NPI 1093020133
987 BOARDMAN CANFIELD RD
Boardman, OH 44512
(330) 965-8760
✔ PECOS✔ Accepts MedicareSame address
Vanessa D'angelo, NP-C
Nurse Practitioner
NPI 1649887142
987 BOARDMAN CANFIELD RD
Youngstown, OH 44512
(330) 965-8760
✔ PECOS✔ Accepts MedicareSame address
Ashley Mckee, NP-C
Nurse Practitioner
NPI 1053200774
987 BOARDMAN CANFIELD RD
Boardman, OH 44512
(330) 965-8760
✔ PECOS✔ Accepts MedicareSame address
Teresa Shaffer, CNP
Nurse Practitioner
NPI 1770092900
987 BOARDMAN CANFIELD RD
Boardman, OH 44512
(330) 271-8589
✔ PECOS✔ Accepts MedicareSame address
John Bernat, M.D.
Dermatology
NPI 1215923115
987 BOARDMAN CANFIELD RD
Boardman, OH 44512
(330) 965-8760
✔ PECOS✔ Accepts MedicareSame address
Patrick Shannon, M.D.
Dermatology
NPI 1316933260
987 BOARDMAN CANFIELD RD
Boardman, OH 44512
(330) 965-8760
✔ PECOS✔ Accepts MedicareSame address
Karynn Schaefer, FNP-BC
Nurse Practitioner
NPI 1386594109
987 BOARDMAN CANFIELD RD
Boardman, OH 44512
(330) 965-8760
✔ PECOS✔ Accepts MedicareSame address
Ann Dechellis, APRN
Nurse Practitioner
NPI 1881206993
1039 BOARDMAN CANFIELD RD STE B
Youngstown, OH 44512
(330) 965-8760
✔ PECOS✔ Accepts Medicare1.4 mi
Rachel Delost, DO
Dermatology
NPI 1659861839
2223 NILES CORTLAND RD SE
Warren, OH 44484
(330) 965-8760
✔ PECOS✔ Accepts Medicare13 mi
Tatum Martino
Nurse Practitioner
NPI 1457847998
2223 NILES CORTLAND RD SE
Warren, OH 44484
(330) 965-8760
✔ PECOS✔ Accepts Medicare13 mi
Randi Toth
Nurse Practitioner
NPI 1710356902
1 PARK WEST BLVD STE 200
Akron, OH 44320
(330) 835-9158
✔ PECOS✔ Accepts Medicare47 mi
David Crowe, MD
Dermatology
NPI 1528256526
8183 GOLDEN LINK BLVD
Macedonia, OH 44067
(330) 306-9844
✔ PECOS✔ Accepts Medicare48 mi
Deborah Paul, MD
Micrographic Dermatologic Surgery (MDS)
NPI 1700371960
8183 GOLDEN LINK BLVD
Macedonia, OH 44067
(330) 778-1278
✔ PECOS48 mi
Amy Polster, MD
Dermatology
NPI 1053341602
8183 GOLDEN LINK BLVD
Macedonia, OH 44067
(330) 778-1278
✔ PECOS✔ Accepts Medicare48 mi
Sherry Yu, M.D.
Dermatology
NPI 1427411149
8183 GOLDEN LINK BLVD
Macedonia, OH 44067
(330) 778-1278
✔ PECOS✔ Accepts Medicare48 mi
Gregory Delost, D.O.
Dermatology
NPI 1073995791
5800 LANDERBROOK DR STE 250
Mayfield Heights, OH 44124
(440) 646-1600
✔ PECOS✔ Accepts Medicare52 mi
Tiffany Wu, MD
Dermatology
NPI 1841879855
3100 WOOSTER RD
Rocky River, OH 44116
(234) 702-1244
✔ PECOS✔ Accepts Medicare67 mi
Kasie Adkins, D.O.
Micrographic Dermatologic Surgery (MDS)
NPI 1205148947
5817 HAPPY HOLLOW RD
Milford, OH 45150
(513) 327-9244
✔ PECOS✔ Accepts Medicare227 mi
Michael Costanzo, NP
Nurse Practitioner
NPI 1245984665
5817 HAPPY HOLLOW RD
Milford, OH 45150
(513) 327-9244
✔ PECOS✔ Accepts Medicare227 mi
Lori Schaen, M.D.
Dermatology
NPI 1326045915
5817 HAPPY HOLLOW RD
Milford, OH 45150
(513) 327-9244
✔ PECOS✔ Accepts Medicare227 mi
See all 57 clinicians

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 5

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 36D2235311

Optima Dermatology Macedonia · Macedonia, OH
Active · expires Dec 5, 2027
CLIA Number36D2235311
Laboratory TypePhysician Office
Certificate Effective DateDecember 6, 2025
Certificate Expiration DateDecember 5, 2027
Laboratory DirectorDr. Sherry Yu
Laboratory Phone(330) 306-9844
Laboratory LocationOptima Dermatology Macedonia8183 Golden Link Blvd, Macedonia, OH 44067
CLIA data matches this NPI record on: Address 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.

Certificate of Waiver 36D2244902

Advanced Dermatology And Skin Cancer Center · Salem, OH
Active · expires Jul 17, 2027
CLIA Number36D2244902
Laboratory TypePhysician Office
Certificate Effective DateJuly 18, 2025
Certificate Expiration DateJuly 17, 2027
Laboratory DirectorCasey Dickey
Laboratory Phone(330) 271-8614
Laboratory LocationAdvanced Dermatology And Skin Cancer Center2525 East State Street, Salem, OH 44460
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 20D2256215

Optima Dermatology - Scarborough · Scarborough, ME
Active · expires Mar 21, 2028
CLIA Number20D2256215
Laboratory TypePhysician Office
Certificate Effective DateMarch 22, 2026
Certificate Expiration DateMarch 21, 2028
Laboratory DirectorVirginia Barton
Laboratory Phone(207) 770-5621
Laboratory LocationOptima Dermatology - Scarborough71 Us Route 1, Suite J, Scarborough, ME 04074
CLIA data matches this NPI record on: Address Name
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.

Certificate of Accreditation 30D2276086

Optima Dermatology Pathology Laboratory · Portsmouth, NH
Active · expires Dec 3, 2026
CLIA Number30D2276086
Laboratory TypeDerm Path Lab
Certificate Effective DateDecember 4, 2024
Certificate Expiration DateDecember 3, 2026
Laboratory DirectorDr. Karen Wu
Laboratory Phone(603) 451-6239
Laboratory LocationOptima Dermatology Pathology Laboratory111 New Hampshire Ave, Ste 3, Portsmouth, NH 03801
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 30D2261768

Optima Dermatology · Salem, NH
Active · expires Mar 16, 2027
CLIA Number30D2261768
Laboratory TypePhysician Office
Certificate Effective DateMarch 17, 2025
Certificate Expiration DateMarch 16, 2027
Laboratory DirectorRyan Karmouta
Laboratory Phone(603) 942-2020
Laboratory LocationOptima Dermatology31 Stiles Rd, Fl2, Ste 2100, Salem, NH 03079
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only 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 Optima Dermatology LLC's NPI number?

The NPI number for Optima Dermatology LLC is 1831187764. It was assigned to this organization in the NPPES registry on October 13, 2005. The provider was formerly known as Advanced Dermatology And Skin Cancer Center LLC.

Where is Optima Dermatology LLC located?

Optima Dermatology LLC is located at 987 Boardman Canfield Rd, Boardman, OH 44512. The listed phone number is (330) 965-8760.

What is Optima Dermatology LLC's specialty?

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

Is Optima Dermatology LLC enrolled in Medicare?

Yes. Optima Dermatology LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Optima Dermatology LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 57 clinicians in 4 Medicare specialties reassign their Medicare billing to Optima Dermatology 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. The largest specialties are Dermatology (31), Nurse Practitioner (19) and Pathology (4). Of these, 7 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Optima Dermatology LLC hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Optima Dermatology LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list Optima Dermatology LLC 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 Optima Dermatology LLC was last updated on July 1, 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.