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OPTIMA DERMATOLOGY LLC
NPI 1831187764
Dermatology in Boardman, OH

Active since October 13, 2005CLIA Certified · 9 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: July 26, 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 9 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
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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 22223 Niles Cortland Rd SEWarren, OH 44484-3043 · Phone (330) 965-8760 · Fax (330) 469-9706
Location 3321 Niles Cortland Rd NE # UnitebWarren, OH 44484-1974 · Phone (330) 800-5963 · Fax (330) 469-9706
Location 42525 E State StSalem, OH 44460-9303 · Phone (330) 271-8614 · Fax (330) 525-9008
Location 55817 Happy Hollow RdMilford, OH 45150-1848 · Phone (513) 327-9244 · Fax (513) 323-5201
Location 67676 Reynolds RdMentor, OH 44060-5110 · Phone (440) 283-3015 · Fax (440) 283-3010
Location 78183 Golden Link BlvdMacedonia, OH 44067 · Phone (330) 778-1278
Location 8911 E Aurora RdMacedonia, OH 44056-1905 · Phone (330) 306-9844 · Fax (330) 525-9009
Location 91027 Boardman Canfield RdBoardman, OH 44512-4227 · Phone (330) 965-8760 · Fax (330) 965-9325
Location 101039 Boardman Canfield RdBoardman, OH 44512-4228 · Phone (330) 271-8589 · Fax (330) 965-9325
Location 1131 Stiles Rd Ste 2100Salem, NH 03079-3035 · Phone (603) 942-2020 · Fax (603) 288-1722
Location 12111 New Hampshire Ave Ste 3Portsmouth, NH 03801-2864 · Phone (603) 988-0951
Location 1371 US Route 1 Ste JScarborough, ME 04074-7168 · Phone (207) 464-2712
Location 142800 S State Road 135 Ste 250Greenwood, IN 46143-6223 · Phone (317) 300-1788 · Fax (317) 743-8103
Location 15824 Edwards DrPlainfield, IN 46168-2791 · Phone (317) 406-3254 · Fax (317) 406-3259
Location 161100 Southfield Dr Ste 1240Plainfield, IN 46168-4499 · Phone (317) 838-9911 · Fax (317) 837-6080
Location 176639 Whitestown PkwyZionsville, IN 46077-7622 · Phone (317) 732-8980 · Fax (317) 732-8979
Location 181010 W 2nd StBloomington, IN 47403-2217 · Phone (812) 200-2458 · Fax (930) 200-8590
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 ›

CLIA Laboratory Certificates CMS CLIA 9

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. Deborah Paul
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) 36D2213948

Optima Dermatology · Mentor, OH
Active · expires Sep 14, 2027
CLIA Number36D2213948
Laboratory TypePhysician Office
Certificate Effective DateSeptember 15, 2025
Certificate Expiration DateSeptember 14, 2027
Laboratory DirectorGregory Delost
Laboratory Phone(855) 277-9689
Laboratory LocationOptima Dermatology7676 Reynolds Road, Mentor, OH 44060
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 Compliance 30D2309996

Optima Dermatology · Portsmouth, NH
Active · expires May 14, 2027
CLIA Number30D2309996
Laboratory TypePhysician Office
Certificate Effective DateMay 15, 2025
Certificate Expiration DateMay 14, 2027
Laboratory DirectorAbel Jarell
Laboratory Phone(855) 277-9689
Laboratory LocationOptima Dermatology215 Commerce Way, Ste 100, Portsmouth, NH 03801
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 15D2275622

Optima Dermatology · Bloomington, IN
Active · expires Jan 24, 2027
CLIA Number15D2275622
Laboratory TypePhysician Office
Certificate Effective DateJanuary 25, 2025
Certificate Expiration DateJanuary 24, 2027
Laboratory DirectorScott T. Guenthner
Laboratory Phone(855) 277-9689
Laboratory LocationOptima Dermatology1010 W 2nd Street, Bloomington, IN 47403
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.

Other Providers at the Same Location NPPES 12

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

ASHLEY MCKEE NP-C
Nurse Practitioner (Family)
987 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512
Mahoning County (330) 965-8760
DR. MARIEL BIRD D.O.
Dermatology
987 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512
Mahoning County (330) 965-8760
ANNE R ZAJAC PA C
Physician Assistant (Medical)
987 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512
Mahoning County (330) 271-8589
JOHN RAYMOND BERNAT M.D.
Specialist
987 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512
Mahoning County (330) 965-8760
PATRICK L. SHANNON M.D.
Specialist
987 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512
Mahoning County (330) 965-8760
KARYNN SCHAEFER FNP-BC
Nurse Practitioner (Family)
987 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512
Mahoning County (330) 965-8760
ADVANCED DERMATOLOGY AND SKIN CANCER CENTER
Clinical Medical Laboratory
987 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512
Mahoning County (330) 965-8760
MRS. SARAH J KUDELKO PA-C
Physician Assistant
987 BOARDMAN CANFIELD RD
BOARDMAN, OH 44512
Mahoning County (330) 965-8760

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.

Does Optima Dermatology LLC hold CLIA laboratory certificates?

Yes. 9 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 Sheld and Anthem Blue Cross and Blue Shield and 2 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 with the weekly NPPES data releases published by CMS.