Active NPI
Cecil Dermatology LLC
- Plastic Surgery Physician
- Elkton, MD
National Provider Identifier
1427190982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- D0053034
- Legal business name
- CECIL DERMATOLOGY LLC
- Practice address
- 304 North St Ste 3
Elkton, MD 21921-5570 - Phone
- (410) 620-9722
- NPI assigned
- Feb 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cindy Groux
- Title
- Billing Manager
- Phone
- (302) 633-5840
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | D0053034 | MD | Primary |
Addresses
Primary practice location
304 North St Ste 3
Elkton, MD 21921-5570
Mailing address
304 North St Ste 3
Elkton, MD 21921-5570
Phone (410) 620-9722
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC3411 | Other | MD | MEDICARE RAILROAD |
| DC3411 | Other | MD | MCR RAILROAD PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
111 W High St
Ste 105
Elkton, MD 21921
Phone (410) 398-7797
304 North St
Ste 3
Elkton, MD 21921
Phone (410) 620-9722
111 W High St
#105
Elkton, MD 21921
Phone (410) 620-3734
360 E Pulaski Hwy
Fl 3
Elkton, MD 21921
Phone (410) 620-9722
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Plastic Surgery Physician
- Elkton, MD
- NPI 1659322501
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652659200000",
"number": "1427190982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 NORTH ST STE 3",
"city": "ELKTON",
"state": "MD",
"postal_code": "219215570",
"telephone_number": "410-620-9722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 NORTH ST STE 3",
"city": "ELKTON",
"state": "MD",
"postal_code": "219215570",
"telephone_number": "410-620-9722"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CECIL DERMATOLOGY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-13",
"last_updated": "2022-05-16",
"certification_date": "2022-05-16",
"status": "A",
"authorized_official_last_name": "GROUX",
"authorized_official_first_name": "CINDY",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "302-633-5840"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": "MD",
"license": "D0053034",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "DC3411",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCR RAILROAD PIN",
"identifier": "DC3411",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elkton, MD
- Cecil County Health Department
- Cecil County Health Department
- Cecil County Infants & Toddlers Program
- Cecil County Pediatrics
- Cecil County Public Schools
- Cecil Imaging Center, LLC
- Cecil Surgery Center, LLC
- Center for Comprehensive Services, Inc
- Center for Interventional Pain Spine LLC
- Center for Interventional Pain Spine LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.