Individual provider Active NPI

Sandra Lee Rebish, MD

  • Dermatology Physician
  • Upland, CA
National Provider Identifier
1235252289
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A81296 Issued in CA
Practice address
859 E Foothill Blvd Ste B
Upland, CA 91786-4085
Phone
(909) 981-8929
Fax
(909) 946-9740
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X A81296 CA
Dermatology Physician 207N00000X A81296 CA Primary

Addresses

Primary practice location

859 E Foothill Blvd Ste B
Upland, CA 91786-4085

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other names 1

  • Dr. Sandra Lee Other name

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
I20041104000701 CA Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 5799683942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
Hahnemann University College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skinphysicians and Surgeons Medical Group IncGroup PAC ID 3971401126, 6 clinicians

Practice addresses (Care Compare)

859 E Foothill Blvd
Suite B
Upland, CA 91786-4085
Phone (909) 981-8929

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions71
Removal of skin cancer56
Removal or shaving of skin growth1-10
Skin biopsy29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81296CAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology - Pacific, P.C. Dermatology CurrentSince Sep 1, 2024 Accepting new patients
Skinphysicians & Surgeons Medical Group, Inc. Dermatology CurrentSince Nov 1, 2004 Accepting new patients
Forefront Dermatology - Pacific, P.C. Dermatology Current Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Forefront Dermatology - Pacific, P.C. Dermatology Past Accepting new patients

Locations

8401 Pine Ave
Ste 120
Chino, CA 91708
Phone (909) 789-0937

15055 Los Gatos Blvd
Ste 100
Los Gatos, CA 95032
Phone (408) 333-9580

639 N 13th Ave
Upland, CA 91786
Phone (909) 532-5588

859 E Foothill Blvd
Ste B
Upland, CA 91786
Phone (909) 981-8929

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1235252289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 E FOOTHILL BLVD STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864085",
            "telephone_number": "909-981-8929",
            "fax_number": "909-946-9740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBISH",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A81296",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A81296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "LEE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.