Placer Dermatology & Skin Care Center Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A72699 Issued in CA

Legal business name

PLACER DERMATOLOGY & SKIN CARE CENTER INC.

Doing business as

Placer Dermatology & Skin Care Center

Practice address

9285 Sierra College Blvd
Roseville, CA 95661

Phone

(916) 784-3376

NPI assigned

Dec 14, 2007

Last updated

Dec 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Artur Z Henke, M.D.NPI 1932287653

Title

Owner

Phone

(916) 797-6261

Specialties & licenses 1

Addresses

Other names 1

• Placer Dermatology & Skin Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DDCFAA

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Artur Z. Henke, MD

  • Dermatology Physician
  • Roseville, CA
  • NPI 1932287653
  Medicare reassignment Authorized official
• Ina Marie Walts, PA-C

  • Physician Assistant
  • Roseville, CA
  • NPI 1215032354
  NPD (past)

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1467635250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9624 WEXFORD CIR",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957467113",
            "telephone_number": "916-797-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9285 SIERRA COLLEGE BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-784-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACER DERMATOLOGY & SKIN CARE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "HENKE",
        "authorized_official_first_name": "ARTUR",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-797-6261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A72699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Placer Dermatology & Skin Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lana Pivovar, LMFT
• Placer County
• Placer County Adult System of Care
• Placer County HHS
• Placer County Mental Health Berkeley
• Placer Medical Center, Inc
• Placer Optometry, Inc.
• Placer Psychological Wellness Group, Inc
• Placer Surgical Associates
• Planned Parenthood Mar Monte, Inc

• Dermatology Physician in Roseville, CA
• Providers in Roseville, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.