Organization Active NPI

On Site Dermatology of Texas PLLC

  • Dermatology Physician
  • Cedar Park, TX
National Provider Identifier
1568808459
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ON SITE DERMATOLOGY OF TEXAS PLLC
Practice address
1103 Cypress Creek Rd Ste 100
Cedar Park, TX 78613-3925
Phone
(877) 345-5300
Fax
(561) 989-3665
NPI assigned
May 17, 2013
Last updated
Jun 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Authorized official

Name
Animesh Sinha, MDNPI 1285733014
Title
Authorized Official
Phone
(561) 314-2000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

1103 Cypress Creek Rd Ste 100
Cedar Park, TX 78613-3925

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 314-2000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130823001230 TX Part B Supplier - Clinic/Group Practice 4082857966 Receives reassigned benefits from 7 practitioners
Practice locations: Bedford, TX; Cedar Park, TX; Denton, TX; Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

1103 Cypress Creek Rd
Ste 100
Cedar Park, TX 78613
Phone (512) 257-7600

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1568808459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-314-2000",
            "fax_number": "561-989-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 CYPRESS CREEK RD STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786133925",
            "telephone_number": "877-345-5300",
            "fax_number": "561-989-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON SITE DERMATOLOGY OF TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-17",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "SINHA",
        "authorized_official_first_name": "ANIMESH",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "561-314-2000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.