Amarillo Dermatology, P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

L5831 Issued in TX

Legal business name

AMARILLO DERMATOLOGY, P.A.

Practice address

4512 Van Winkle Dr
Amarillo, TX 79119

Phone

(806) 358-1497

Fax

(806) 358-1375

NPI assigned

Jul 20, 2005

Organization subpart

No

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

Authorized official

Name

Edward McCarthy, MDNPI 1902803976

Title

Physician/Partner

Phone

(806) 358-1497

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Edward Michael McCarthy, MD

  • Dermatology Physician
  • Amarillo, TX
  • NPI 1902803976
  Medicare reassignment Care Compare group NPD Authorized official
• Rebecca A. McCarthy, MD

  • Dermatology Physician
  • Amarillo, TX
  • NPI 1770581464
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1619976685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 VAN WINKLE DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79119",
            "telephone_number": "806-358-1497",
            "fax_number": "806-358-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 VAN WINKLE DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79119",
            "telephone_number": "806-358-1497",
            "fax_number": "806-358-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARILLO DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN/PARTNER",
        "authorized_official_telephone_number": "806-358-1497",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "L5831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157343801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amarillo Dental Associates
• Amarillo Denture Clinic, PLLC
• Amarillo Diagnostic Clinic RX Inc
• Amarillo Diagnostic Clinic RX Inc
• Amarillo Diagnostic Clinic, P.a.
• Amarillo Emergency Center LLC
• Amarillo Emergency Physicians LLP

• Dermatology Physician in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.