NPIMap

Organization Active NPI

Center for Excellence in Dermatology PLLC

  • Specialist
  • Hermiston, OR
National Provider Identifier
1093061806
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CENTER FOR EXCELLENCE IN DERMATOLOGY PLLC
Practice address
1050 W Elm Ave
Suite #220
Hermiston, OR 97838-2700
Phone
(509) 735-1100
Fax
(509) 735-1180
NPI assigned
Jul 30, 2012
Last updated
Jun 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Authorized official

Name
Robert B HoppNPI 1801835509
Title
Owner
Phone
(509) 735-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1050 W Elm Ave
Suite #220
Hermiston, OR 97838-2700

Mailing address

8901 W Gage Blvd
Kennewick, WA 99336-7148
Phone (509) 735-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120817000135 OR Part B Supplier - Clinic/Group Practice 8527123306 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Hermiston, OR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
38D2046774Center for Excellence in Dermatology1050 W Elm St Suite 220, Hermiston, OR 97838ComplianceFeb 11, 2027

National Provider Directory

National Provider Directory

Locations

8901 W Gage Blvd
Kennewick, WA 99336
Phone (509) 628-1911

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1093061806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 W GAGE BLVD",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367148",
            "telephone_number": "509-735-1100",
            "fax_number": "509-735-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W ELM AVE",
            "address_2": "SUITE #220",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978382700",
            "telephone_number": "509-735-1100",
            "fax_number": "509-735-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR EXCELLENCE IN DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-30",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "HOPP",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-735-1100"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermiston, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.