Saint Paul Dermatology LTD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SAINT PAUL DERMATOLOGY LTD

Practice address

400 Selby Ave Ste S
Saint Paul, MN 55102-4520

Phone

(523) 734-1239

Fax

(651) 383-4947

NPI assigned

May 17, 2018

Organization subpart

No

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

Authorized official

Name

Anastasios Pappas, MDNPI 1912904970

Title

MD/Owner

Phone

(651) 354-8105

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18162/brand/1/csg/1/fhir/r4

Practitioners 1

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.

• Anastasios Angelo Pappas, M.D.

  • Dermatology Physician
  • Saint Paul, MN
  • NPI 1912904970
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1184114803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 DAYTON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021709",
            "telephone_number": "651-354-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SELBY AVE STE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551024520",
            "telephone_number": "523-734-1239",
            "fax_number": "651-383-4947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7100 Northland Cir N Ste 119",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554281500",
            "country_code": "US",
            "telephone_number": "952-373-4123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAINT PAUL DERMATOLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-17",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "PAPPAS",
        "authorized_official_first_name": "ANASTASIOS",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "651-354-8105",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Saint Paul Medical Supplies
• Ramasubbu Sairam, MD
• Nazifa Sajady, M.D.
• Sakura Pelvic Health and Wellness
• Fadumo Adan Salad

• Dermatology Physician in Saint Paul, MN
• Providers in Saint Paul, 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 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.