Cheryl Lee Danielle Eberting, M.D.
Individual provider Active NPI Dermatology Physician · Alpine, UT
NPI 1306945308 · NPPES record last updated Sep 3, 2009
Key facts
- NPI
- 1306945308
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 62699311205 (UT)
- Practice address
- 144 S Main St
Suite 100
Alpine, UT 84004-1666 - Phone
- (801) 763-7107
- Fax
- (801) 763-7607
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- University of Utah School of Medicine, 2000
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Alpine Dermatology PC
Practice addresses (Care Compare)
144 S Main St
Suite 100
Alpine, UT 84004-1667
Phone (801) 763-7107
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 66 |
| Skin biopsy | 29 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070220000040 | UT | Practitioner - Dermatology | 4688656788 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62699311205 | UT | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Azova Care Group (FL), PLLC | Current | Accepting new patients | |
| Alpine Dermatology PC | Dermatology | Current |
Accepting new patients |
Locations
100 Pine St
Ste 1250
San Francisco, CA 94111
Phone (415) 390-5445
144 S Main St
Ste 100
Alpine, UT 84004
Phone (801) 367-3725
1320 Central Park Blvd
Ste 200
Fredericksburg, VA 22401
Phone (540) 623-7198
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 62699311205 | UT | Yes |
Addresses
Primary practice location
144 S Main St
Suite 100
Alpine, UT 84004-1666
Mailing address
653 S High Bench Rd
Alpine, UT 84004-1797
Phone (801) 763-7107
Other providers in Alpine, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.