Scott C Rackett M D Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G83929 Issued in CA

Legal business name

SCOTT C RACKETT M D INC

Doing business as

Manhattan Beach Dermatology

Practice address

2809 N Sepulveda Blvd
Manhattan Beach, CA 90266-2727

Phone

(310) 802-8180

NPI assigned

Jun 12, 2007

Organization subpart

No

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

Authorized official

Name

Scott C. Rackett, MDNPI 1235230368

Title

Owner

Phone

(310) 802-8180

Specialties & licenses 1

Addresses

Other names 1

• Manhattan Beach Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Curtis Rackett, M.D.

  • Dermatology Physician
  • Manhattan Beach, CA
  • NPI 1235230368
  Medicare reassignment Care Compare group NPD Authorized official
• Dina Farshidi Bierman, M.D.

  • MOHS-Micrographic Surgery Physician
  • Santa Monica, CA
  • NPI 1659627115

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Daniela Moura Leslie, N.P.

  • Family Nurse Practitioner
  • Redondo Beach, CA
  • NPI 1255668885
  Medicare reassignment NPD
• Kristin Egan, M.D.

  • Facial Plastic Surgery Physician
  • Manhattan Beach, CA
  • NPI 1669500302
  NPD (past)

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1235333493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662727",
            "telephone_number": "310-802-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 N SEPULVEDA BLVD",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662727",
            "telephone_number": "310-802-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT C RACKETT M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "RACKETT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-802-8180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G83929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manhattan Beach Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lois Schunk, MFT
• Richard Martin Schwarz, D.C.
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• Theodore Seeds
• Theresa Serrano, PT, DPT
• Castoria Seymore Jr., MD

• Dermatology Physician in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.