NPIMap

Organization Active NPI

Palos Verdes Skin Surgery Ctr Inc

Doing business as Palos Verdes Dermatology Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Rolling Hills Estates, CA
National Provider Identifier
1285028803
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PALOS VERDES SKIN SURGERY CTR INC
Doing business as
Palos Verdes Dermatology Surgery Center, Inc.
Practice address
550 Deep Valley Dr
Suite 283
Rolling Hills Estates, CA 90274-3664
Phone
(310) 541-7800
Fax
(310) 541-7808
NPI assigned
Mar 20, 2015
Last updated
Jun 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Dr. Howard Fein, MD
Title
Medical Director
Phone
(310) 541-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

550 Deep Valley Dr
Suite 283
Rolling Hills Estates, CA 90274-3664

Mailing address

550 Deep Valley Dr
Suite 283
Rolling Hills Estates, CA 90274-3664
Phone (310) 541-7800

Other names 1

  • Palos Verdes Dermatology Surgery Center, Inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150626001291 CA Part B Supplier - Ambulatory Surgical Center 8224340633 Receives reassigned benefits from 2 practitioners
Practice locations: Rolling Hills Estates, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Palos Verdes Skin Surgery Ctr Inc Dba Palos Verdes Dermatology Surgery Center IncCCN 05C0002117
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Palos Verdes Dermatology Surgery Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1285028803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 DEEP VALLEY DR",
            "address_2": "SUITE 283",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743664",
            "telephone_number": "310-541-7800",
            "fax_number": "310-541-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 DEEP VALLEY DR",
            "address_2": "SUITE 283",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743664",
            "telephone_number": "310-541-7800",
            "fax_number": "310-541-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOS VERDES SKIN SURGERY CTR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-20",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "FEIN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-541-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palos Verdes Dermatology Surgery Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolling Hills Estates, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.