NPIMap

Organization Active NPI

Huntington Dermatology Medical Group Inc

  • Dermatology Physician
  • Pasadena, CA
National Provider Identifier
1275664435
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
HUNTINGTON DERMATOLOGY MEDICAL GROUP INC
Practice address
800 Fairmount Ave
Suite 425
Pasadena, CA 91105-3150
Phone
(415) 802-1310
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Dr. Seth Anthony Vaccaro, M.D.NPI 1477560951
Title
Owner
Phone
(415) 802-1310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

800 Fairmount Ave
Suite 425
Pasadena, CA 91105-3150

Mailing address

800 Fairmount Ave
Suite 425
Pasadena, CA 91105-3150
Phone (415) 802-1310

Other names 1

  • Dynasty Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050621001323 CA Part B Supplier - Clinic/Group Practice 6709821697 Receives reassigned benefits from 8 practitioners
Practice locations: Pasadena, CA

National Provider Directory

National Provider Directory

Locations

800 Fairmount Ave
Ste 425
Pasadena, CA 91105
Phone (626) 449-9992

248 N Altadena Dr
Pasadena, CA 91107

248 N Altadena Dr
Ste 201
Pasadena, CA 91107

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)…

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00155

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1275664435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE",
            "address_2": "SUITE 425",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053150",
            "telephone_number": "415-802-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIRMOUNT AVE",
            "address_2": "SUITE 425",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053150",
            "telephone_number": "415-802-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTINGTON DERMATOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "VACCARO",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-802-1310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dynasty Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.