Organization Active NPI

Dermatology Associates of Denison PLLC

  • Specialist
  • Denison, TX
National Provider Identifier
1699111476
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
M6969 Issued in TX
Legal business name
DERMATOLOGY ASSOCIATES OF DENISON PLLC
Practice address
5130 Pool Road, Suite 200
Denison, TX 75020-4506
Phone
(903) 463-2223
Fax
(903) 463-2224
NPI assigned
May 20, 2013
Last updated
Oct 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Priya Zeikus, MDNPI 1245267434
Title
Owner
Phone
(903) 463-2223

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X M6969 TX Primary

Addresses

Primary practice location

5130 Pool Road, Suite 200
Denison, TX 75020-4506

Mailing address

5130 Pool Road, Suite 200
Denison, TX 75020-4506
Phone (903) 463-2223

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130925000773 TX Part B Supplier - Clinic/Group Practice 7416191812 Receives reassigned benefits from 5 practitioners
Practice locations: Denison, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2054717Dermatology Associates of Denison PLLC5130 Pool Road Suite 200, Denison, TX 75020ComplianceMay 5, 2027

National Provider Directory

National Provider Directory

Locations

5012 US Highway 75
Ste 200
Denison, TX 75020
Phone (903) 463-2223

5130 Pool Rd
Ste 200
Denison, TX 75020
Phone (903) 463-2223

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1699111476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 POOL ROAD, SUITE 200",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204506",
            "telephone_number": "903-463-2223",
            "fax_number": "903-463-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 POOL ROAD, SUITE 200",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750204506",
            "telephone_number": "903-463-2223",
            "fax_number": "903-463-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF DENISON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-20",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "ZEIKUS",
        "authorized_official_first_name": "PRIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-463-2223",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "M6969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.