Peninsula Dermatology Medical Group Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PENINSULA DERMATOLOGY MEDICAL GROUP INC

Practice address

1750 El Camino Real
Ste 206
Burlingame, CA 94010

Phone

(650) 692-0182

Fax

(650) 692-7741

NPI assigned

Oct 24, 2006

Last updated

Oct 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Donald M Kay, M.D.

Title

President

Phone

(650) 692-0182

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 7

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.

• Karen Laszlo Keller, MD

  • Dermatology Physician
  • Burlingame, CA
  • NPI 1437157054
  Medicare reassignment Care Compare group NPD
• Nikolajs Armand Lapins, M.D.

  • Dermatology Physician
  • Burlingame, CA
  • NPI 1346247228
  Medicare reassignment Care Compare group NPD
• Janet Maldonado, M.D.

  • Dermatology Physician
  • Burlingame, CA
  • NPI 1518099977
  Medicare reassignment Care Compare group NPD
• Jennifer L Sorrell, M.D.

  • Pediatric Dermatology Physician
  • Los Gatos, CA
  • NPI 1487827861
  Medicare reassignment Care Compare group NPD
• Sarah Tuttleton Arron, M.D., PH.D.

  • MOHS-Micrographic Surgery Physician
  • Burlingame, CA
  • NPI 1255463725
  Medicare reassignment NPD
• Silke Heinisch, MD, PHD

  • Dermatology Physician
  • Soquel, CA
  • NPI 1649590910
  Medicare reassignment NPD
• Daria Beatriz Maldonado-Knapp, M.D.

  • Dermatology Physician
  • Monterey, CA
  • NPI 1659482149
  Medicare reassignment

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1699858233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 EL CAMINO REAL",
            "address_2": "STE 206",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "94010",
            "telephone_number": "650-692-0182",
            "fax_number": "650-692-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 EL CAMINO REAL",
            "address_2": "STE 206",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "94010",
            "telephone_number": "650-692-0182",
            "fax_number": "650-692-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA DERMATOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "KAY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-692-0182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "ZZZ20101Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pear Holdings, LLC (Peninsula Post-Acute)
• Mark Newman Pederson, M.D.
• Jessie Peng, NP-C
• Peninsula Allergy Associates, a Medical Group Inc.
• Peninsula Child and Family Therapy Inc
• Peninsula Endoscopy Center LLC (Mid Peninsula Endoscopy Center)
• Peninsula Heights Diagnostic Laboratories, Inc.
• Peninsula Hospitalist Associates, Inc.
• Peninsula Medical Group
• Peninsula Neurological Associates

• Dermatology Physician in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.