Individual provider Active NPI

Marcus L. Elias, MD

  • Dermatology Physician
  • Wilkes Barre, PA
National Provider Identifier
1407483118
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD494428 Issued in PA
Practice address
1155 East MTN Blvd
Wilkes Barre, PA 18702-7906
Phone
(570) 808-6113
Fax
(570) 808-6349
NPI assigned
Mar 24, 2020
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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 MD494428 PA Primary
Dermatology Physician 207N00000X 35.150702 OH

Addresses

Primary practice location

1155 East MTN Blvd
Wilkes Barre, PA 18702-7906

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 808-6113

Other practice location 1

3025 Governors Place Blvd
Dayton, OH 45409-1330
Phone (937) 293-5567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240604004393 OH Practitioner - Dermatology 5991247017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Rutgers New Jersey Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Skin Surgery Center IncGroup PAC ID 2365455276, 8 clinicians

Practice addresses (Care Compare)

3025 Governors Place Blvd
Dayton, OH 45409-1330
Phone 9372935567127

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision47
Removal of tissue1-10
Removal of skin lesions336
Removal or shaving of skin growth1-10
Skin biopsy195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD494428PAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Skin Surgery Center Inc CurrentSince May 15, 2024 Accepting new patients

Locations

3025 Governors Place Blvd
Kettering, OH 45409
Phone (937) 293-5567

Interoperability endpoints

  • Direct secure messaging: marcus.eliasmd.p1@direct.daytonskin.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1407483118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-808-6113",
            "fax_number": "570-808-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 EAST MTN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027906",
            "telephone_number": "570-808-6113",
            "fax_number": "570-808-6349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3025 Governors Place Blvd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454091330",
            "country_code": "US",
            "telephone_number": "937-293-5567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELIAS",
        "first_name": "MARCUS",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD494428",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.150702",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.