Katy Dermatology, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

L5711 Issued in TX

Legal business name

KATY DERMATOLOGY, P.A.

Practice address

21310 Provincial Blvd
Katy, TX 77450-7580

Phone

(281) 599-0404

Fax

(281) 599-1655

NPI assigned

Jun 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Adam J Czelusta, M.D.NPI 1033110929

Title

Owner

Phone

(281) 599-0404

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Locations

Practitioners 8

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

• Adam J Czelusta, MD

  • Dermatology Physician
  • Katy, TX
  • NPI 1033110929
  Medicare reassignment Care Compare group NPD Authorized official
• Samantha Emily Carter, M.D.

  • Specialist
  • Katy, TX
  • NPI 1073520839
  Medicare reassignment Care Compare group NPD
• Jennifer A Hickman, MD

  • Specialist
  • Houston, TX
  • NPI 1881739779
  Medicare reassignment Care Compare group NPD
• Sindy Pang, MD

  • Dermatology Physician
  • Houston, TX
  • NPI 1831114826
  Medicare reassignment Care Compare group NPD
• David Joseph Uptmore Jr., MD

  • Dermatology Physician
  • Katy, TX
  • NPI 1649317819
  Medicare reassignment Care Compare group NPD
• Sana Hashmi Zahiruddin, M.D.

  • Dermatology Physician
  • Katy, TX
  • NPI 1154764868
  Medicare reassignment Care Compare group NPD
• Rani Michelle Cooper, M.D.

  • Dermatology Physician
  • Katy, TX
  • NPI 1285839084
  Medicare reassignment NPD
• Erik Thomas Petersen, M.D.

  • MOHS-Micrographic Surgery Physician
  • Houston, TX
  • NPI 1043621048
  NPD (past)

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1346446051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21310 PROVINCIAL BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-599-0404",
            "fax_number": "281-599-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21310 PROVINCIAL BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-599-0404",
            "fax_number": "281-599-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATY DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "CZELUSTA",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-599-0404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "L5711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4516713",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168278301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0074LM",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katy Dental
• Katy Dental Arts, PLLC
• Katy Dental Group, PLLC (The Dental People)
• Katy Dental Studio
• Katy Dentists PA
• Katy Diabetes and Endocrinology PLLC
• Katy Diagnostics Associates PLLC (Katy Sleep and Wellness)
• Katy DME, LLC
• Katy Dreamweaver Home Health Care
• Katy Emergency Center Inc

• Specialist in Katy, TX
• Providers in Katy, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.