Individual provider Active NPI

Peter John Morrell, D.O.

  • Dermatology Physician
  • Beaumont, TX
National Provider Identifier
1679809362
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M8197 Issued in TX
Practice address
3560 Delaware St
Suite 901
Beaumont, TX 77706-3000
Phone
(409) 898-3900
Fax
(409) 898-3901
NPI assigned
Oct 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X M8197 TX Primary
MOHS-Micrographic Surgery Physician 207ND0101X M8197 TX

Addresses

Primary practice location

3560 Delaware St
Suite 901
Beaumont, TX 77706-3000

Mailing address

3560 Delaware St
Suite 901
Beaumont, TX 77706-3000
Phone (409) 898-3900

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20120702000097 TX Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 0244408169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of North Texas HSC, College of Osteopathic Med, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3560 Delaware St
Beaumont, TX 77706-3000
Phone (409) 898-3900

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision98
Removal of tissue1-10
Removal of skin lesions2538
Removal of skin cancer512
Removal or shaving of skin growth1-10
Skin biopsy992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
M8197TXMDDermatology Physician
5022OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Morrell Dermatology, P.a. Dermatology CurrentSince Jun 1, 2012 Accepting new patients

Locations

3560 Delaware St
Ste 901
Beaumont, TX 77706
Phone (409) 898-3900

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1679809362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST",
            "address_2": "SUITE 901",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063000",
            "telephone_number": "409-898-3900",
            "fax_number": "409-898-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 DELAWARE ST",
            "address_2": "SUITE 901",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777063000",
            "telephone_number": "409-898-3900",
            "fax_number": "409-898-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRELL",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-30",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M8197",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "TX",
            "license": "M8197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.