Organization Active NPI

Twin Cities Dermatology Center, PA

  • Dermatology Physician
  • Minneapolis, MN
National Provider Identifier
1164930541
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
980103100020 Issued in MN
Legal business name
TWIN CITIES DERMATOLOGY CENTER, PA
Practice address
5000 W 36TH St Ste 205
Minneapolis, MN 55416-2760
Phone
(919) 282-6766
NPI assigned
Jan 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Margareth Pierre-Louis, MDNPI 1063731065
Title
Incorporator
Phone
(612) 268-5005

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 980103100020 MN Primary

Addresses

Primary practice location

5000 W 36TH St Ste 205
Minneapolis, MN 55416-2760

Mailing address

5000 W 36TH St Ste 205
Minneapolis, MN 55416-2760
Phone (612) 268-5005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180327002023 MN Part B Supplier - Clinic/Group Practice 9931461159 Receives reassigned benefits from 1 practitioner
Practice locations: Minneapolis, MN

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
24D2150718Twin Cities Dermatology Center, PA5000 W 36TH St, Ste 205, Minneapolis, MN 55416ComplianceJan 23, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00308

Practitioners & affiliated clinicians

Practitioners 1

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": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1164930541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 W 36TH ST STE 205",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554162760",
            "telephone_number": "612-268-5005",
            "fax_number": "612-268-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W 36TH ST STE 205",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554162760",
            "telephone_number": "919-282-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES DERMATOLOGY CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "PIERRE-LOUIS",
        "authorized_official_first_name": "MARGARETH",
        "authorized_official_title_or_position": "INCORPORATOR",
        "authorized_official_telephone_number": "612-268-5005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "MN",
            "license": "980103100020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.