NPIMap

Organization Active NPI

Forefront Dermatology - Pacific, P.C.

  • Dermatology Physician
  • Thousand Oaks, CA
National Provider Identifier
1356535009
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
FOREFRONT DERMATOLOGY - PACIFIC, P.C.
Practice address
267 W Hillcrest Dr
Thousand Oaks, CA 91360-4211
Phone
(805) 497-1694
Fax
(805) 373-7493
NPI assigned
Sep 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Dr. Betsy J Wernli, MD
Title
President
Phone
(920) 482-0671

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0900X
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X

Addresses

Primary practice location

267 W Hillcrest Dr
Thousand Oaks, CA 91360-4211

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

105 W Mission St
Santa Barbara, CA 93101-2899
Phone (805) 682-7874

Other practice location 2

5565 Carpinteria Ave Ste 3
Carpinteria, CA 93013-1446
Phone (805) 745-1013

Other names 1

  • Forefront Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031219000212 CA Part B Supplier - Clinic/Group Practice 8325946015 Receives reassigned benefits from 25 practitioners
4 other NPIs on this enrollment
Practice locations: Carpinteria, CA; Chino, CA; Los Gatos, CA; Santa Barbara, CA; Santa Cruz, CA; Thousand Oaks, CA; Upland, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0584696Forefront Dermatology - Pacific, PC105 W Mission St, Santa Barbara, CA 93101ComplianceMay 27, 2027
05D0858484Forefront Dermatology - Pacific, PC267 W Hillcrest Dr, Thousand Oaks, CA 91360ComplianceMar 12, 2027

National Provider Directory

National Provider Directory

Locations

267 W Hillcrest Dr
Thousand Oaks, CA 91360
Phone (805) 497-1694

Practitioners & affiliated clinicians

Practitioners 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1356535009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 W HILLCREST DR",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604211",
            "telephone_number": "805-497-1694",
            "fax_number": "805-373-7493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 W Mission St",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931012899",
            "country_code": "US",
            "telephone_number": "805-682-7874",
            "fax_number": "805-682-7875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5565 Carpinteria Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Carpinteria",
            "state": "CA",
            "postal_code": "930131446",
            "country_code": "US",
            "telephone_number": "805-745-1013",
            "fax_number": "805-364-4817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY - PACIFIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "WERNLI",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-482-0671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forefront Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.