Individual provider Active NPI

Cristina Isabel Tarantola, MD

  • MOHS-Micrographic Surgery Physician
  • Pensacola, FL
National Provider Identifier
1396816765
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
ME112087 Issued in FL
Practice address
525 Brent LN
Pensacola, FL 32503-2003
Phone
(850) 439-5394
Fax
(850) 696-2613
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME112087 FL
MOHS-Micrographic Surgery Physician 207ND0101X ME112087 FL Primary

Addresses

Primary practice location

525 Brent LN
Pensacola, FL 32503-2003

Mailing address

525 Brent LN
Pensacola, FL 32503-2003
Phone (850) 439-5394

Other identifiers 1

IdentifierTypeStateIssuer
014407000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120515000591 FL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 1951309913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of Florida College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tarantola Dermatology IncGroup PAC ID 6204141872, 3 clinicians

Practice addresses (Care Compare)

525 Brent LN
Pensacola, FL 32503-2003
Phone (850) 439-5394

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as individual
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision44
Removal of skin lesions2607
Removal of skin cancer712
Removal or shaving of skin growth1-10
Skin biopsy1353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1396816765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 BRENT LN",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032003",
            "telephone_number": "850-439-5394",
            "fax_number": "850-696-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 BRENT LN",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032003",
            "telephone_number": "850-439-5394",
            "fax_number": "850-696-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARANTOLA",
        "first_name": "CRISTINA",
        "middle_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME112087",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME112087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014407000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.