Individual provider Active NPI

Jeffrey W Collins, D.O.

  • Dermatology Physician
  • Santa Rosa, CA
National Provider Identifier
1174942403
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
19114 Issued in CA
Practice address
6574 Oakmont Dr Ste B
Santa Rosa, CA 95409-5958
Phone
(707) 579-4239
Fax
(707) 579-0459
NPI assigned
Apr 15, 2014
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X OS13861 FL
Dermatology Physician 207N00000X 19114 CA Primary

Addresses

Primary practice location

6574 Oakmont Dr Ste B
Santa Rosa, CA 95409-5958

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 948-0291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211117001865 CA Practitioner - Dermatology 6507199619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Dermatology of Santa Rosa PCGroup PAC ID 4183033079, 6 clinicians

Practice addresses (Care Compare)

6574 Oakmont Dr
Suite B
Santa Rosa, CA 95409-5958
Phone (707) 579-4239

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.33 of 100Reported as group
Quality
66.67
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision177
Removal of skin lesions1720
Removal of skin cancer323
Removal or shaving of skin growth33
Skin biopsy502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS13861FLMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Dermatology of Lakeport, PC Dermatology CurrentSince Dec 15, 2021 Accepting new patients
Integrated Dermatology of Santa Rosa, PC Dermatology CurrentSince Sep 29, 2021 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Lake Dermatology Medical Assoc Inc Dermatology PastSince Dec 15, 2021 Accepting new patients

Locations

301 East St
Healdsburg, CA 95448
Phone (707) 433-4239

5144 Hill Rd E
Lakeport, CA 95453
Phone (707) 263-4541

4739 Hoen Ave
Santa Rosa, CA 95405
Phone (707) 528-4239

6574 Oakmont Dr
Ste B
Santa Rosa, CA 95409
Phone (707) 542-5664

4700 Exchange Ct
Ste 110
Boca Raton, FL 33431
Phone (561) 223-8081

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1174942403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6574 OAKMONT DR STE B",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954095958",
            "telephone_number": "707-579-4239",
            "fax_number": "707-579-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS13861",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "19114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.