Dynamic Dermatology, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

DYNAMIC DERMATOLOGY, PLLC

Practice address

13535 Hausman Pass Ste 104
San Antonio, TX 78249-3581

Phone

(210) 951-5530

Fax

(210) 951-9080

NPI assigned

May 10, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Sarah Groff, MDNPI 1497192082

Title

President

Phone

(210) 951-5530

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Practitioners 3

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

• Sarah Elizabeth Groff, MD

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1497192082
  Medicare reassignment Care Compare group NPD Authorized official
• Daniella Guajardo Arellano, PA-C

  • Medical Physician Assistant
  • San Antonio, TX
  • NPI 1689064602
  Medicare reassignment Care Compare group
• Vanessa Marie Hinojosa, PAC

  • Physician Assistant
  • San Antonio, TX
  • NPI 1578903688
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1043876568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13535 HAUSMAN PASS STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13535 HAUSMAN PASS STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493581",
            "telephone_number": "210-951-5530",
            "fax_number": "210-951-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-10",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "GROFF",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-951-5530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Dyjak, LPC
• Heather Dykes, M.S., CCC-SLP
• Kenneth Ray Dykes, RPH
• Lisa Ann Dykes
• Brady Dylla
• Dynamic Medical LLC
• Dynamic Wound Care
• Mary Elizabeth Dyson, MD
• DZ Industries
• Nata Dzadzamia, BCBA

• Medical Specialty Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Medical Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.