Lakeshore Derm & Laser Center PLC
NPI 1538209945 · Procedural Dermatology Physician · Norton Shores, MI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lakeshore Derm & Laser Center PLC is a Procedural Dermatology Physician organization in Norton Shores, MI (NPI 1538209945).
Provider details
- NPI number
- 1538209945
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jason Van Ittersum, Owner(231) 798-9500
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-02-07
- Last updated
- 2013-10-22
Frequently asked questions
- What is Lakeshore Derm & Laser Center PLC's NPI number?
- Lakeshore Derm & Laser Center PLC's National Provider Identifier (NPI) is 1538209945, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lakeshore Derm & Laser Center PLC?
- Lakeshore Derm & Laser Center PLC is classified in the NPPES registry as Procedural Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Lakeshore Derm & Laser Center PLC located?
- Lakeshore Derm & Laser Center PLC's practice location on file with NPPES is 6225 Prairie St, Norton Shores, MI 49444-7831.
- What is Lakeshore Derm & Laser Center PLC's phone number?
- The practice phone number listed in the NPPES registry for Lakeshore Derm & Laser Center PLC is (231) 798-9500.
- Does Lakeshore Derm & Laser Center PLC accept Medicare?
- Lakeshore Derm & Laser Center PLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lakeshore Derm & Laser Center PLC?
- The authorized official listed on Lakeshore Derm & Laser Center PLC's NPPES record is Jason Van Ittersum, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lakeshore Derm & Laser Center PLC's NPI active?
- Yes — Lakeshore Derm & Laser Center PLC's NPI (1538209945) is active in the NPPES registry as of the last update on 2013-10-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.