Organization Active NPI

Dermcheck PLLC

  • Dermatology Physician
  • Bradenton, FL
National Provider Identifier
1407634074
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMCHECK PLLC
Practice address
8614 State Road 70 E Ste 101
Bradenton, FL 34202-3710
Phone
(941) 779-3334
Fax
(941) 761-5818
NPI assigned
Sep 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Peter Mattei, MDNPI 1013195759
Title
Owner
Phone
(609) 330-2168

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X

Addresses

Primary practice location

8614 State Road 70 E Ste 101
Bradenton, FL 34202-3710

Mailing address

8614 State Road 70 E Ste 101
Bradenton, FL 34202-3710
Phone (941) 779-3334

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231009000997 FL Part B Supplier - Clinic/Group Practice 4082069208 Receives reassigned benefits from 1 practitioner
Practice locations: Bradenton, FL

National Provider Directory

National Provider Directory

Locations

8614 State Road 70 E
Ste 101
Lakewood Ranch, FL 34202
Phone (941) 737-8927

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1407634074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 STATE ROAD 70 E STE 101",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342023710",
            "telephone_number": "941-779-3334",
            "fax_number": "941-761-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8614 STATE ROAD 70 E STE 101",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342023710",
            "telephone_number": "941-779-3334",
            "fax_number": "941-761-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMCHECK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "MATTEI",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-330-2168",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.