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BENEDETTO DERMATOLOGY, LLC
NPI 1972771129
Dermatology - MOHS-Micrographic Surgery in Philadelphia, PA

Active since February 11, 2008
1200 LOCUST ST, PHILADELPHIA, PA 19107(215) 546-3666(215) 546-6060 Get Directions Write a Review

NPPES record last updated: December 16, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Benedetto Dermatology, Llc NPPES

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

BENEDETTO DERMATOLOGY, LLC (NPI 1972771129) is a healthcare organization registered as a mohs-micrographic surgery in Philadelphia, Pennsylvania and active in the NPI registry since February 2008. The organization lists Anthony V Benedetto, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1972771129
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameBENEDETTO DERMATOLOGY, LLC
Location Address1200 LOCUST STPhiladelphia, PA 19107-5605
Mailing Address1200 Locust StPhiladelphia, PA 19107-5605 · (215) 546-3666 · Fax (215) 546-6060
Phone(215) 546-3666
Fax(215) 546-6060
Organization SubpartNo
Authorized OfficialAnthony V BenedettoMedical Director · (215) 546-3666
Enumeration DateFebruary 11, 2008
Last NPPES UpdateDecember 16, 2014
✔ NPI 1972771129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in PA · 207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
1200 LOCUST ST, Philadelphia, PA 19107
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Other Identifiers 3

Medicare NSC0010175000PA
Other101750PA · Highmark Blue Shield
Other0274011000PA · Independence Blue Cross

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Benedetto Dermatology, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Anthony Benedetto, D.O.
Dermatology
NPI 1831154871
1200 LOCUST ST
Philadelphia, PA 19107
(215) 546-3666
✔ PECOS✔ Accepts MedicareSame address
Ernest Benedetto, M.D.
Dermatology
NPI 1538100540
1200 LOCUST ST
Philadelphia, PA 19107
(215) 546-3666
✔ PECOSSame address
Conrad Benedetto, D.O.
Dermatology
NPI 1154718849
2221 GARRETT RD
Drexel Hill, PA 19026
(610) 623-5885
✔ PECOS✔ Accepts Medicare6.5 mi
Jason Schoenfeld, M.D.
Dermatology
NPI 1942647078
9501 ROOSEVELT BLVD STE 506
Philadelphia, PA 19114
(610) 288-2908
✔ PECOS✔ Accepts Medicare12 mi
Paul Benedetto, M.D.
Dermatology
NPI 1134393028
5701 N. UNIVERSITY DR.
Coral Springs, FL 33067
(954) 659-5264
✔ PECOS✔ Accepts Medicare985 mi
Jonathan Staidle, M.D.
Dermatology
NPI 1982994455
4814 SPARKS BLVD
Sparks, NV 89436
(775) 327-0699
✔ PECOS✔ Accepts Medicare2,348 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Benedetto Dermatology, LLC's NPI number?

The NPI number for Benedetto Dermatology, LLC is 1972771129. It was assigned to this organization in the NPPES registry on February 11, 2008.

Where is Benedetto Dermatology, LLC located?

Benedetto Dermatology, LLC is located at 1200 Locust St, Philadelphia, PA 19107. The listed phone number is (215) 546-3666.

What is Benedetto Dermatology, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Benedetto Dermatology, LLC enrolled in Medicare?

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

How many clinicians bill Medicare through Benedetto Dermatology, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Dermatology, reassign their Medicare billing to Benedetto 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. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Benedetto Dermatology, LLC was last updated on December 16, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.