Main Street Dermatology, PLLC
NPI 1881371946 · Dermatology Physician · Clarkston, MI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Main Street Dermatology, PLLC is a Dermatology Physician organization in Clarkston, MI (NPI 1881371946).
Provider details
- NPI number
- 1881371946
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kenzie Gardner, Nurse Practitioner, Operator(614) 507-3765
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
2 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
- 2023-06-30
- Last updated
- 2023-08-03
- Certified
- 2023-08-03
Frequently asked questions
- What is Main Street Dermatology, PLLC's NPI number?
- Main Street Dermatology, PLLC's National Provider Identifier (NPI) is 1881371946, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Main Street Dermatology, PLLC?
- Main Street Dermatology, PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Main Street Dermatology, PLLC located?
- Main Street Dermatology, PLLC's practice location on file with NPPES is 5885 S Main St Ste 1, Clarkston, MI 48346-2981.
- What is Main Street Dermatology, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Main Street Dermatology, PLLC is (248) 238-8059.
- Does Main Street Dermatology, PLLC accept Medicare?
- Main Street Dermatology, PLLC 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 Main Street Dermatology, PLLC?
- The authorized official listed on Main Street Dermatology, PLLC's NPPES record is Kenzie Gardner, Nurse Practitioner, Operator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Main Street Dermatology, PLLC's NPI active?
- Yes — Main Street Dermatology, PLLC's NPI (1881371946) is active in the NPPES registry as of the last update on 2023-08-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.