DERMATOLOGY CENTER FOR CHILDREN & YOUNG ADULTS PA – NPI #1053417055
Dermatology

A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents.

Health Care Provider Taxonomy Code for Dermatology

DERMATOLOGY CENTER FOR CHILDREN & YOUNG ADULTS PA is a dermatologist located in EAGAN, MN. NPPES has assigned the NPI number 1053417055 to DERMATOLOGY CENTER FOR CHILDREN & YOUNG ADULTS PA on September 16, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207NP0225X from the Health Care Provider Taxonomy code set, which is classified as Dermatology, specializing in Pediatric Dermatology

The NPI profile was previously updated about 18 years ago on Apr 20, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DERMATOLOGY CENTER FOR CHILDREN & YOUNG ADULTS PA below.

NPI Profile for
DERMATOLOGY CENTER FOR CHILDREN & YOUNG ADULTS PA

NPI Number
1053417055
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DERMATOLOGY CENTER FOR CHILDREN & YOUNG ADULTS PA
Primary location
2795 PILOT KNOB RD
SUITE 300
EAGAN, MN 55121-1176
Phone: (651) 379-9999 Fax: (651) 379-9900
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
KENNETH BLOOM
PRESIDENT
Phone: (651) 379-9999
Updated
Identifiers

Identifiers for DERMATOLOGY CENTER FOR CHILDREN & YOUNG ADULTS PA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERBLUE CROSS BLUE SHIELD2M741DE
MEDICAIDND013837
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207NP0225X
- Dermatology / Pediatric Dermatology (Primary)		 MN

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.