Advanced Dermatologic Surgery, P.a.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

ADVANCED DERMATOLOGIC SURGERY, P.A.

Doing business as

Advanced Dermatologic Surgery
Trinity Dermatology

Practice address

6901 W 121St St
Overland Park, KS 66209-2007

Phone

(913) 661-1755

Fax

(913) 661-9260

NPI assigned

Jul 24, 2007

Last updated

Jun 3, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Greg Albers, MPA

Title

Cfo

Phone

(913) 661-1755

Specialties & licenses 3

Addresses

Other names 2

• Advanced Dermatologic Surgery Doing business as
• Trinity Dermatology Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BHJIBA
• Direct secure messaging: thomas.hocker@advderm.eclinicaldirectplus.com

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Lewis Hamaguchi Hocker, M.D.

  • MOHS-Micrographic Surgery Physician
  • Overland Park, KS
  • NPI 1689841025

  MO

  Medicare reassignment Care Compare group NPD
• Carson Tyler Williams, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Leawood, KS
  • NPI 1477998284
  Medicare reassignment Care Compare group NPD
• Richard Bottoms, FNP-C

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1932508801

  KS

  Medicare reassignment NPD
• Spyros Michael Siscos, MD

  • MOHS-Micrographic Surgery Physician
  • Kansas City, MO
  • NPI 1154826204

  KS

  Medicare reassignment NPD
• Isadore Tarantino

  • Dermatology Physician
  • Saint Joseph, MO
  • NPI 1689036261

  KS

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1003016312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 W 121ST ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092007",
            "telephone_number": "913-661-1755",
            "fax_number": "913-661-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 W 121ST ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092007",
            "telephone_number": "913-661-1755",
            "fax_number": "913-661-9260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 N Cosby Ave",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641512377",
            "country_code": "US",
            "telephone_number": "816-643-4501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGIC SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "ALBERS",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "913-661-1755",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KS",
            "license": "04-25136",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KS",
            "license": "04-25136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.hocker@advderm.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6901 W 121st St",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662092007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Advanced Dermatologic Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Dermatologic Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trinity Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• MOHS-Micrographic Surgery Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• MOHS-Micrographic Surgery Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.