Kelly Jean Stankiewicz, MD, FAAD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

10172206-1205 Issued in UT

Practice address

The Dermatology House-1922 Prospector Ave.
Park City, UT 84060

Phone

(435) 602-1918

Fax

(435) 731-8109

NPI assigned

May 2, 2007

Last updated

Sep 23, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Dermatology

Education

Indiana University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Dermatology House PCGroup PAC ID 9335411446, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Dermatology House PC

  • Dermatology Physician
  • Park City, UT
  • NPI 1316470750
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1598987307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE DERMATOLOGY HOUSE-1922 PROSPECTOR AVE.",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84060",
            "telephone_number": "435-602-1918",
            "fax_number": "435-731-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE DERMATOLOGY HOUSE-1922 PROSPECTOR AVE.",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84060",
            "telephone_number": "435-602-1918",
            "fax_number": "435-731-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANKIEWICZ",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "MD, FAAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036128182",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "10172206-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spenser Reed MD PLLC
• Greg Speziale
• Adriana Angela Sta Agueda
• Earl Warren Stadler Jr., M.D.
• Debra Lynn Stafsholt, PT
• Starpath Inc
• Stat MD LLC
• Stat-MD I
• Kortney James Stirland, RPH
• Robert Maxwell Stirling, PA-C

• Dermatology Physician in Park City, UT
• Providers in Park City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.