Daphne I Panagotacos MD

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

G66971 Issued in CA

Legal business name

DAPHNE I PANAGOTACOS MD

Practice address

32144 Agoura Rd
Suite 106
Westlake Village, CA 91361-4031

Phone

(805) 379-3376

Fax

(805) 379-3267

NPI assigned

Jul 18, 2008

Last updated

Jul 31, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Debbie Ickes

Title

Practice Administrator

Phone

(805) 379-3376

Specialties & licenses 3

Addresses

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

Tax ID family

Daphne I Panagotacos MD2 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.

• Daphne I Panagotacos MD

  • Specialist
  • Westlake Village, CA
  • NPI 1740378280
  NPD tax ID

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 7

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.

• Clayton T Hinshaw, MD

  • Procedural Dermatology Physician
  • Simi Valley, CA
  • NPI 1326043456
  Medicare reassignment NPD
• Jeanine A Ishak, N.P.

  • Nurse Practitioner
  • Westlake Village, CA
  • NPI 1962456475
  Medicare reassignment NPD
• Daphne I Panagotacos, MD

  • Dermatology Physician
  • Westlake Village, CA
  • NPI 1811091069

  Mohs-Micrographic Surgery

  Medicare reassignment NPD
• Stephanie R Porter, NP

  • Family Nurse Practitioner
  • Thousand Oaks, CA
  • NPI 1396238929
  Medicare reassignment NPD
• Kristy Brigham, FNP-BC

  • Family Nurse Practitioner
  • Coeur d'Alene, ID
  • NPI 1134749898

  CA

  Medicare reassignment NPD
• Mojan R Deriss, PA-C

  • Physician Assistant
  • Westlake Village, CA
  • NPI 1740740372

  Single Specialty

  NPD
• Juana Martinez

  • Physician Assistant
  • Westlake Village, CA
  • NPI 1922869700
  NPD

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343692800000",
    "number": "1295999274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD",
            "address_2": "SUITE 106",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614031",
            "telephone_number": "805-379-3376",
            "fax_number": "805-379-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD",
            "address_2": "SUITE 106",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614031",
            "telephone_number": "805-379-3376",
            "fax_number": "805-379-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAPHNE I PANAGOTACOS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-18",
        "last_updated": "2012-07-31",
        "status": "A",
        "authorized_official_last_name": "ICKES",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "805-379-3376",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "G66971",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G66971",
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "G66971",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judiann Rgoei Dakoske, MA
• Thomas John Dakoske, PSYCHOLOGIST
• Chelsea Daley
• Emma Dangaard, ACSW
• Kim Dorothy Dannenberg, NP
• Daphne I Panagotacos MD
• John Joseph Darin, M.D.
• Darren Osterloh OD Inc
• Brett Darrington, D.C.
• Jena Laurette Darvey

• Dermatopathology Physician in Westlake Village, CA
• Providers in Westlake Village, CA by specialty
• Dermatopathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; 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.