Cleveland Skin Pathology Laboratory, Inc

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

CLIA 36D0656050 Issued in OH

Legal business name

CLEVELAND SKIN PATHOLOGY LABORATORY, INC

Practice address

3737 Park East Drive
Suite #202
Beachwood, OH 44122

Phone

(216) 464-7770

Fax

(216) 464-7531

NPI assigned

Jan 11, 2006

Last updated

Sep 21, 2017By 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

Dina Valladares

Title

Director of Credentialing & Pe

Phone

(561) 514-5822

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Cleveland Skin Pathology Laboratory, Inc

  • Dermatopathology (Pathology) Physician
  • Beachwood, OH
  • NPI 1669332987

  9537237664

  Same PAC ID

Practitioners 2

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.

• Timothy T Chang, M.D.

  • Dermatopathology Physician
  • Cleveland, OH
  • NPI 1447372446
  NPD
• Yuan Yu Huang, M.D.

  • Dermatology Physician
  • Cleveland, OH
  • NPI 1366973059
  NPD (past)

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505952000000",
    "number": "1336128164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11025 RCA CENTER DRIVE",
            "address_2": "SUITE 300",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33410",
            "telephone_number": "561-514-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 PARK EAST DRIVE",
            "address_2": "SUITE #202",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-464-7770",
            "fax_number": "216-464-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND SKIN PATHOLOGY LABORATORY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2017-09-21",
        "status": "A",
        "authorized_official_last_name": "VALLADARES",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING & PE",
        "authorized_official_telephone_number": "561-514-5822"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "OH",
            "license": "CLIA 36D0656050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "36D0656050",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252560",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cleveland Hearing & Balance Center Inc
• Cleveland Kidney Disease Associates
• Cleveland Nutrition, LLC
• Cleveland Pain Management and Acupuncture LLC
• Cleveland Shoulder Institute, LLC
• Cleveland Skin Pathology Laboratory, Inc
• Clinic Regional Physicians LLC
• Kimberly Katherine Clipper, LPCC
• Colleen Cloherty
• Christy Clore

• Dermatopathology Physician in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Dermatopathology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; 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.