Northcoast Dermatology Associates, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

NORTHCOAST DERMATOLOGY ASSOCIATES, INC.

Doing business as

Northcoast Dermatology

Practice address

4807 Rockside Rd Ste 100
Independence, OH 44131-2188

Phone

(216) 524-4009

Fax

(216) 524-7933

NPI assigned

Apr 21, 2006

Last updated

May 12, 2026By 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. Rachel Mistur, MDNPI 1033504501

Title

Dermatologist / Owner

Phone

(216) 524-4009

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Northcoast Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Northcoast Dermatology Associates, Inc.

  dba Northcoast Dermatology

  • Dermatology Physician
  • Independence, OH
  • NPI 1780994517

  O20050525000446

  Same enrollment

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Northcoast Dermatology Associates, Inc.

  dba Northcoast Dermatology

  • Dermatology Physician
  • Independence, OH
  • NPI 1780994517
  NPPES parent name

Practitioners 5

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.

• Rachel Mistur, MD

  • Dermatology Physician
  • Independence, OH
  • NPI 1033504501

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Carol G Burg, MD

  • Dermatology Physician
  • Independence, OH
  • NPI 1992761068
  Medicare reassignment Care Compare group NPD
• Mary Teresa Sivik, MD

  • Dermatology Physician
  • Independence, OH
  • NPI 1841256013
  Medicare reassignment Care Compare group NPD
• Stephanie Wallace, APRN CNP

  • Family Nurse Practitioner
  • Independence, OH
  • NPI 1194416792
  Medicare reassignment Care Compare group NPD
• Marlene Willen, MD

  • Dermatology Physician
  • Independence, OH
  • NPI 1215955661
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1750347480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 ROCKSIDE RD STE 100",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312188",
            "telephone_number": "216-524-4009",
            "fax_number": "216-524-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 ROCKSIDE RD STE 100",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312188",
            "telephone_number": "216-524-4009",
            "fax_number": "216-524-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHCOAST DERMATOLOGY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "MISTUR",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "DERMATOLOGIST / OWNER",
        "authorized_official_telephone_number": "216-524-4009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-INDEP",
            "identifier": "CC5264",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0271423",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0289727",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE SAG",
            "identifier": "CD6030",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northcoast Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in Independence, OH
• Providers in Independence, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.