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Good Faith Estimate

Comprehensive initial consultation — $250

Estimate of expected charges for a self-pay telemedicine dermatology consultation. This is an estimate, not a bill, and not a confirmation that any appointment has been scheduled or paid.

About Good Faith Estimates

Practice and provider

Practice
Dermatologic Services, PLLC
Provider
Gibran Shaikh, MD
Service delivery
Telemedicine video consultation
Administrative mailing address
20 W Spring Ave, Ardmore, PA 19003
Email
manager@dermatologicservices.com
Phone
347-291-1877
Effective date
September 17, 2026
Last updated
September 17, 2026

Mail and correspondence only — not a patient care location.

Expected service and charge

Service
Comprehensive initial consultation
Duration
30 minutes directly with Dr. Shaikh
Billing code
99204
Expected charge
$250
Quantity
1 consultation
Total expected charge
$250

Level of service is determined after the visit based on documented complexity.

Payment is collected at the time of scheduling. This practice is cash-pay and does not bill insurance for the visit.

What is not included

This estimate covers the consultation listed above only. It does not include prescription medications or pharmacy charges, laboratory testing, pathology, imaging, procedures, in-person care, or services provided by another provider or facility. Those items are billed separately by whoever provides them, and this practice cannot estimate their cost.

Your rights

This Good Faith Estimate shows the cost of items and services that are reasonably expected for your health care needs for a self-pay telemedicine dermatology consultation with Dermatologic Services, PLLC. The estimate is based on information known at the time it was created and does not include items or services that may be recommended during or after your visit, such as prescription medications, laboratory testing, pathology, imaging, procedures, or care from another provider or facility. Those would be billed separately by whoever provides them. This estimate is not a contract and does not require you to obtain the items or services listed.

You have the right to receive a Good Faith Estimate in writing at least one business day before your visit, and you may ask for one at any time before scheduling. If you are billed at least $400 more than this Good Faith Estimate, you may be eligible to dispute the bill through the federal patient-provider dispute resolution process. You must start the dispute process within 120 calendar days of the date on your bill. Keep a copy of this Good Faith Estimate. For questions or a copy of your estimate, contact us at manager@dermatologicservices.com or 347-291-1877. For more information about your rights, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Dermatologic Services, PLLC is a cash-pay (self-pay) practice. Fees are not billed to any insurance plan, and amounts paid are not applied to an insurance deductible. Patients enrolled in Medicare or Medicare Advantage are not able to book online and are asked to contact the practice so we can review the visit before any appointment is made.

Federal information about these protections is published at cms.gov/nosurprises.

Scheduling and payment are completed in the Google Calendar window. Your official confirmation and appointment details will be sent by email after successful payment.

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See available times and book · $250