Village Dermatology & Cosmetic Surgery, LLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

OS8364 Issued in FL

Legal business name

VILLAGE DERMATOLOGY & COSMETIC SURGERY, LLC

Practice address

1950 Laurel Manor Dr
Building 220, Suite 224
The Villages, FL 32162

Phone

(352) 751-6565

Fax

(352) 205-7777

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Thi Thien TranNPI 1437117116

Title

Owner/Physician

Phone

(352) 751-6565

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thi Thien Tran, DO

  • Dermatology Physician
  • The Villages, FL
  • NPI 1437117116

  Procedural Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Vickie Hodges, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • The Villages, FL
  • NPI 1275151227
  Medicare reassignment Care Compare group NPD
• Rani Marie Powierza, NP-BC

  • Gerontology Nurse Practitioner
  • The Villages, FL
  • NPI 1992231021
  Medicare reassignment Care Compare group NPD
• Joyiena Rose Joseph, PA-C

  • Physician Assistant
  • The Villages, FL
  • NPI 1447875810
  Medicare reassignment Care Compare group
• Michelle Gibson Shinham, PA-C

  • Physician Assistant
  • Ocala, FL
  • NPI 1003139395
  Medicare reassignment Care Compare group
• Laura Erika Dermenjian, PA

  • Physician Assistant
  • The Villages, FL
  • NPI 1255316907
  Medicare reassignment
• Heather M Gates, PA-C

  • Physician Assistant
  • The Villages, FL
  • NPI 1366726986
  Medicare reassignment

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570752000000",
    "number": "1013098755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 LAUREL MANOR DR",
            "address_2": "BUILDING 220, SUITE 224",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625603",
            "telephone_number": "352-751-6565",
            "fax_number": "352-205-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 LAUREL MANOR DR",
            "address_2": "BUILDING 220, SUITE 224",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "32162",
            "telephone_number": "352-751-6565",
            "fax_number": "352-205-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE DERMATOLOGY & COSMETIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-10-11",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "THI",
        "authorized_official_middle_name": "THIEN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "352-751-6565"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "OS8364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yeny Valladares Gonzalez, APRN
• Peter Anthony Vasallo III, MD
• Jean Vernet Vilce, PHARM D
• Villa Health Pulmonary LLC
• Village Center Community Development District
• Village Gynecology MD PA
• Village Nutritionist
• Village Sleep Lab & Breathing Center Inc
• Villages Healthcare Services, LLC
• Villages Internal Medicine and Senior Clinic PA

• Procedural Dermatology Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Procedural Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.