Optima Dermatology LLC
NPI 1831187764 · Dermatology Physician · Boardman, OH
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1831187764
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- John Bernat, Authorized Official(330) 965-8760
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- MOHS-Micrographic Surgery Physician207ND0101X
Allopathic & Osteopathic Physicians
- Dermatopathology Physician207ND0900X
Allopathic & Osteopathic Physicians
- Anatomic Pathology Physician207ZP0101X
Allopathic & Osteopathic Physicians
- Specialist174400000X
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
21 documented practice locations
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
Other names (DBA / former)
- Former legal business name
- Advanced Dermatology and Skin Cancer Center LLC
- Former legal business name
- Advanced Dermatology and Skin Cancer Center LLC
Additional practice locations (20)
- 1010 W 2nd StBloomington, IN 47403-2217Phone: (812) 200-2458Fax: (930) 200-8590
- 2800 S State Road 135 Ste 250Greenwood, IN 46143-6223Phone: (317) 300-1788Fax: (317) 743-8103
- 824 Edwards DrPlainfield, IN 46168-2791Phone: (317) 406-3254Fax: (317) 406-3259
- 1100 Southfield Dr Ste 1240Plainfield, IN 46168-4499Phone: (317) 838-9911Fax: (317) 837-6080
- 6639 Whitestown PkwyZionsville, IN 46077-7622Phone: (317) 732-8980Fax: (317) 732-8979
- 29 Sebago RdRaymond, ME 04071-6823Phone: (207) 838-9073Fax: (207) 203-4875
- 71 US Route 1 Ste JScarborough, ME 04074-7168Phone: (207) 464-2712
- 1 Hampton Rd Unit A306Exeter, NH 03833-4848Phone: (603) 942-2171Fax: (603) 371-3104
Registry dates
- Enumerated
- 2005-10-13
- Last updated
- 2024-07-01
- Certified
- 2024-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.