Menlo Dermatology Medical Group and Laser Center Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

26176 Issued in CA

Legal business name

MENLO DERMATOLOGY MEDICAL GROUP AND LASER CENTER INC

Practice address

888 Oak Grove Ave
Suite 8
Menlo Park, CA 94025-4432

Phone

(650) 325-1511

Fax

(650) 325-6174

NPI assigned

Feb 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Edward Hoffman, M.D.NPI 1063435741

Title

President

Phone

(650) 325-1511

Specialties & licenses 1

Addresses

Other identifiers 1

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

Locations

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 3

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

• Jodie L Bogomilsky, M.D.

  • Specialist
  • Menlo Park, CA
  • NPI 1104849710
  Medicare reassignment Care Compare group NPD
• Thomas Edward Hoffman, M.D.

  • Dermatology Physician
  • Palo Alto, CA
  • NPI 1063435741

  Specialist

  Medicare reassignment NPD Authorized official
• Honor Fullerton Stone, M.D.

  • Specialist
  • Menlo Park, CA
  • NPI 1962425496
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1275509465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 OAK GROVE AVE",
            "address_2": "SUITE 8",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254432",
            "telephone_number": "650-325-1511",
            "fax_number": "650-325-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 OAK GROVE AVE",
            "address_2": "SUITE 8",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254432",
            "telephone_number": "650-325-1511",
            "fax_number": "650-325-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENLO DERMATOLOGY MEDICAL GROUP AND LASER CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-27",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-325-1511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "26176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ15375Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Medina, M.A., P.C.C.I
• Melissa A Meek, ASW
• Samir Mehta, M.D.
• Sinda Marian Mein, MD
• Jenna Mendonca
• Menlo Park Ophthalmology Medical Group
• Menlo Park Pain Relief Center
• Menlo Park Pain Relief Center
• Menlo Park Plastic Surgery Center
• Menlo Park Surgical Hospital

• Specialist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.