Maryland Skin Cancer Specialists, PA

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

MARYLAND SKIN CANCER SPECIALISTS, PA

Practice address

75 Thomas Johnson Dr Ste H
Frederick, MD 21702-4895

Phone

(240) 453-0050

Fax

(301) 668-9853

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

David Mezebish, MDNPI 1720059736

Title

President

Phone

(240) 453-0050

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Enrollment records 2

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 4

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

• David S Mezebish, M.D.

  • MOHS-Micrographic Surgery Physician
  • Frederick, MD
  • NPI 1720059736

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Corey Dewitt, MD

  • MOHS-Micrographic Surgery Physician
  • Leesburg, VA
  • NPI 1417342890

  MD, Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Erin Louise McClure, P.A.-C

  • Physician Assistant
  • Frederick, MD
  • NPI 1003135997
  Medicare reassignment Care Compare group
• Allan Crane Harrington, M.D.

  • MOHS-Micrographic Surgery Physician
  • Fort Myers, FL
  • NPI 1497723050
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1083799688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 THOMAS JOHNSON DR STE H",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024895",
            "telephone_number": "301-668-9850",
            "fax_number": "301-668-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 THOMAS JOHNSON DR STE H",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024895",
            "telephone_number": "240-453-0050",
            "fax_number": "301-668-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SKIN CANCER SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "MEZEBISH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-453-0050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "889AMA",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS CHOICE",
            "identifier": "J819",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• MOHS-Micrographic Surgery Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• MOHS-Micrographic Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.