Active NPI
Rochester Skin Cancer Center, P.C.
- MOHS-Micrographic Surgery Physician
- Rochester Hills, MI
National Provider Identifier
1053500454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- MOHS-Micrographic Surgery Physician
- Legal business name
- ROCHESTER SKIN CANCER CENTER, P.C.
- Practice address
- 405 Barclay Cir
Rochester Hills, MI 48307-4573 - Phone
- (248) 293-0800
- NPI assigned
- Oct 22, 2007
- Last updated
- May 12, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer E McDonald
- Title
- Business Office Manager
- Phone
- (248) 293-0800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | NU | Primary |
Addresses
Primary practice location
405 Barclay Cir
Rochester Hills, MI 48307-4573
Mailing address
405 Barclay Cir
Rochester Hills, MI 48307-4573
Phone (248) 293-0800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5607758 | Other | MI | AETNA |
| 070F322730 | Other | MI | BLUE CROSS BLUE SHIELD |
| DB75711 | Other | MI | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0986830 | Rochester Skin Cancer Center | Compliance | Aug 24, 2027 |
National Provider Directory
National Provider DirectoryInteroperability endpoints
- https://fhir4.healow.com/fhir/r4/IAJHCD
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- MOHS-Micrographic Surgery Physician
- Rochester Hills, MI
- NPI 1467469197
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193011200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1431388800000",
"number": "1053500454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 BARCLAY CIR",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483074573",
"telephone_number": "248-293-0800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 BARCLAY CIR",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483074573",
"telephone_number": "248-293-0800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROCHESTER SKIN CANCER CENTER, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-22",
"last_updated": "2015-05-12",
"status": "A",
"authorized_official_last_name": "MCDONALD",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
"authorized_official_telephone_number": "248-293-0800"
},
"taxonomies": [
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5607758",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "070F322730",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DB75711",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rochester Hills, MI
- Rochester Neurological Center, PC
- Rochester Pediatrics, P.C.
- Rochester Primary Care
- Rochester Primary Care Holdings
- Rochester Rheumatology Research Center PLLC
- Rochester Surgery Center, P.C.
- Rochester Urgent Care Walk-in Clinic
- Rochester Urgent Care, P. C.
- Rochester Urgent Care, P.C.
- Rochester Urology PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.