Associated Skin Care Specialists, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ASSOCIATED SKIN CARE SPECIALISTS, PA

Practice address

3833 Coon Rapids Blvd NW Ste 280
Coon Rapids, MN 55433-2597

Phone

(763) 571-4000

Fax

(763) 502-2966

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Amy M Pogorelec

Title

Business Office Manager

Phone

(763) 502-2937

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Tax ID family

Associated Skin Care 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.

• Associated Skin Care Specialists

  • Dermatology Physician
  • Fridley, MN
  • NPI 1457885444
  NPD tax ID

Locations

Practitioners 22

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

• Gabriel Jerome Amon, MD

  • Dermatology Physician
  • Eden Prairie, MN
  • NPI 1982233599
  Medicare reassignment Care Compare group NPD
• Olivia Michele Crum, MD

  • MOHS-Micrographic Surgery Physician
  • Rochester, MN
  • NPI 1730718263

  Dermatology

  Medicare reassignment Care Compare group NPD
• Bart Theodore Endrizzi, M.D/PH.D.

  • MOHS-Micrographic Surgery Physician
  • Fridley, MN
  • NPI 1235323585
  Medicare reassignment Care Compare group NPD
• Frederick S Fish, M.D.

  • MOHS-Micrographic Surgery Physician
  • Fridley, MN
  • NPI 1346281250

  Specialist

  Medicare reassignment Care Compare group NPD
• Jeffrey M Freed, M.D.

  • Specialist
  • Fridley, MN
  • NPI 1437195872
  Medicare reassignment Care Compare group NPD
• Holly Christine Hanson, M.D.

  • Dermatology Physician
  • Eden Prairie, MN
  • NPI 1023337946
  Medicare reassignment Care Compare group NPD
• Jamie Lea Hanson

  • Dermatology Physician
  • Saint Paul, MN
  • NPI 1386006054
  Medicare reassignment Care Compare group NPD
• Steven E Kempers, M.D.

  • Specialist
  • Fridley, MN
  • NPI 1003852427
  Medicare reassignment Care Compare group NPD
• Bailey C Lee, M.D.

  • Dermatology Physician
  • Fridley, MN
  • NPI 1225292535
  Medicare reassignment Care Compare group NPD
• Jane S Lindholm, M.D.

  • Specialist
  • Fridley, MN
  • NPI 1821034240
  Medicare reassignment Care Compare group NPD
• Jane H Lisko, M.D.

  • Specialist
  • Fridley, MN
  • NPI 1619910890
  Medicare reassignment Care Compare group NPD
• Erin Leigh Luxenberg Hammer, M.D.

  • Dermatology Physician
  • Minneapolis, MN
  • NPI 1750600565
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1083659569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 14TH ST NW STE 240",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551120007",
            "telephone_number": "763-571-4000",
            "fax_number": "763-502-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW STE 280",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332597",
            "telephone_number": "763-571-4000",
            "fax_number": "763-502-2966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11107 Ulysses St NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554344264",
            "country_code": "US",
            "telephone_number": "763-571-4000",
            "fax_number": "763-502-2966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASSOCIATED SKIN CARE SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "POGORELEC",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "763-502-2937"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelyn Jayne Argo, DNP, APRN, FNP-C
• Destini Artis
• Kallie J Ascheman
• Carrie Ashland Murphy, OTD
• Sara Asmus
• At Home Health Care Inc.
• Sarah Lynn Parker Atkins, M.D.
• Moustapha Atoui, M.D
• Paul L. Aubart, RN
• Joylene Mae Audette, PT

• Dermatology Physician in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.