NPIMap

Organization Active NPI

Peninsula Dermatology Skin Cancer Surgery Center, Inc

Doing business as Dermatology Specialists

  • Dermatology Physician
  • Newport News, VA
National Provider Identifier
1063524593
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
PENINSULA DERMATOLOGY SKIN CANCER SURGERY CENTER, INC
Doing business as
Dermatology Specialists
Practice address
11844 Rock Landing Dr Ste B
Newport News, VA 23606-4202
Phone
(757) 873-0161
Fax
(757) 873-0205
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Authorized official

Name
Allison Turkovich
Title
Administrator
Phone
(757) 873-0161

Specialties & licenses 2

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

Addresses

Primary practice location

11844 Rock Landing Dr Ste B
Newport News, VA 23606-4202

Mailing address

11844 Rock Landing Dr Ste B
Newport News, VA 23606-4202
Phone (757) 873-0161

Other names 1

  • Dermatology Specialists Doing business as

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address cmarcuson@directaddress.net
Direct Messaging Address jragi@directaddress.net
Direct Messaging Address jmazzurco@directaddress.net
Direct Messaging Address ehimes@directaddress.net
Direct Messaging Address dshenenberger@directaddress.net
Direct Messaging Address jtacastacas@directaddress.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071009000186 VA Part B Supplier - Clinic/Group Practice 4486749223 Receives reassigned benefits from 10 practitioners
Practice locations: Newport News, VA; Williamsburg, VA

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
49D0686618Peninsula Dermatology Skin Cancer Surgery Center11844 Rock Landing Drive - Suite B, Newport News, VA 23606ComplianceAug 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dermatology Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

475 McLaws Cir
Ste 1
Williamsburg, VA 23185
Phone (757) 259-9466

Interoperability endpoints

  • Direct secure messaging: dshenenberger@directaddress.net
  • Direct secure messaging: cmarcuson@directaddress.net
  • Direct secure messaging: jtacastacas@directaddress.net

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1063524593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11844 ROCK LANDING DR STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064202",
            "telephone_number": "757-873-0161",
            "fax_number": "757-873-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11844 ROCK LANDING DR STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064202",
            "telephone_number": "757-873-0161",
            "fax_number": "757-873-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA DERMATOLOGY SKIN CANCER SURGERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "TURKOVICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "757-873-0161"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmarcuson@directaddress.net",
            "affiliation": "N",
            "address_1": "11844 Rock Landing Dr Ste B",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jragi@directaddress.net",
            "affiliation": "N",
            "address_1": "11844 Rock Landing Dr Ste B",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmazzurco@directaddress.net",
            "affiliation": "N",
            "address_1": "11844 Rock Landing Dr Ste B",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehimes@directaddress.net",
            "affiliation": "N",
            "address_1": "11844 Rock Landing Dr Ste B",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dshenenberger@directaddress.net",
            "affiliation": "N",
            "address_1": "11844 Rock Landing Dr Ste B",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtacastacas@directaddress.net",
            "affiliation": "N",
            "address_1": "11844 Rock Landing Dr Ste B",
            "city": "Newport News",
            "state": "VA",
            "country_code": "US",
            "postal_code": "236064202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Dermatology Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.