West Oak Dermatology Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

123615 Issued in CA

Legal business name

WEST OAK DERMATOLOGY INC

Practice address

258 Gibson Dr
Ste 140
Roseville, CA 95678-5881

Phone

(916) 755-0077

Fax

(916) 755-0099

NPI assigned

Oct 23, 2017

Last updated

Aug 13, 2018By 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

Kathryn Boyse Gant, MDNPI 1598981763

Title

Owner

Phone

(916) 755-0077

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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://app.meldrx.com/api/fhir/ez_00321

Practitioners 4

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.

• Kathryn Boyse Gant, M.D.

  • Dermatology Physician
  • Roseville, CA
  • NPI 1598981763
  Medicare reassignment Care Compare group NPD Authorized official
• Nancy Cote, N.P

  • Adult Health Nurse Practitioner
  • Roseville, CA
  • NPI 1568401735
  Medicare reassignment Care Compare group NPD
• Allen Markovic, PA-C

  • Physician Assistant
  • Sacramento, CA
  • NPI 1184015182
  Medicare reassignment Care Compare group
• Wendy B. Mazursky, PA-C, MS

  • Physician Assistant
  • Hercules, CA
  • NPI 1255425583
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534118400000",
    "number": "1003327545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 GIBSON DR",
            "address_2": "STE 140",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785881",
            "telephone_number": "916-755-0077",
            "fax_number": "916-755-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 GIBSON DR",
            "address_2": "STE 140",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785881",
            "telephone_number": "916-755-0077",
            "fax_number": "916-755-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST OAK DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-23",
        "last_updated": "2018-08-13",
        "status": "A",
        "authorized_official_last_name": "GANT",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "BOYSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-755-0077",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "123615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Werner, MS
• Olivia Zieve Wernick, LCSW
• Robert Mark Wertz, MD
• Linda Ann Wesely, PT
• West Coast Psychiatry Associates, PC (West Coast Psychiatry)
• Terri West, RN
• Sherrilyn Robertson Westbrook, PH.D.
• Elaine Susan Westendorf, LCSW
• Western Clinical Laboratory Inc
• Western Dental Services, Inc.

• Dermatology Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; 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.