Organization Active NPI

Morrell Dermatology, P.a.

  • Dermatology Physician
  • Beaumont, TX
National Provider Identifier
1033485669
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M8197 Issued in TX
Legal business name
MORRELL DERMATOLOGY, P.A.
Practice address
3560 Delaware St
Suite 901
Beaumont, TX 77706-3000
Phone
(409) 898-3900
Fax
(409) 898-3901
NPI assigned
Mar 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Dr. Peter Morrell, D.O.NPI 1679809362
Title
President/Owner
Phone
(409) 898-3900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X M8197 TX Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X M8197 TX

Addresses

Primary practice location

3560 Delaware St
Suite 901
Beaumont, TX 77706-3000

Mailing address

3560 Delaware St
Suite 901
Beaumont, TX 77706-3000
Phone (409) 898-3900

Other identifiers 1

IdentifierTypeStateIssuer
45D2042281OtherTXCLIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000411 TX Part B Supplier - Clinic/Group Practice 2668637620 Receives reassigned benefits from 1 practitioner
Practice locations: Beaumont, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2042281Morrell Dermatology, PA3560 Delaware Suite 901, Beaumont, TX 77706ComplianceJan 29, 2028

National Provider Directory

National Provider Directory

Locations

3560 Delaware St
Ste 901
Beaumont, TX 77706
Phone (409) 898-3900

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1033485669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST",
            "address_2": "SUITE 901",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063000",
            "telephone_number": "409-898-3900",
            "fax_number": "409-898-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST",
            "address_2": "SUITE 901",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063000",
            "telephone_number": "409-898-3900",
            "fax_number": "409-898-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRELL DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "MORRELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "409-898-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M8197",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "M8197",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D2042281",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.