Organization Active NPI

Houston Institute of Dermatology, PLLC

  • Dermatology Physician
  • Houston, TX
National Provider Identifier
1760721278
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M7042 Issued in TX
Legal business name
HOUSTON INSTITUTE OF DERMATOLOGY, PLLC
Practice address
2565 Bay Area Blvd
Houston, TX 77058-1521
Phone
(281) 480-7272
Fax
(281) 480-7273
NPI assigned
Feb 4, 2013
Last updated
Feb 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Dr. Cindy N Berthelot, MDNPI 1114132099
Title
MD/Owner
Phone
(281) 480-7272

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
Dermatology Physician 207N00000X M7042 TX Primary

Addresses

Primary practice location

2565 Bay Area Blvd
Houston, TX 77058-1521

Mailing address

PO Box 273144
Houston, TX 77277-3144
Phone (281) 480-7272

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130628000396 TX Part B Supplier - Clinic/Group Practice 4880834647 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, 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
45D2055300Houston Institute of Dermatology2565 Bay Area Blvd, Houston, TX 77058Provider-performed microscopyMar 7, 2027

National Provider Directory

National Provider Directory

Locations

2565 Bay Area Blvd
Houston, TX 77058
Phone (281) 480-7272

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1760721278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 273144",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772773144",
            "telephone_number": "281-480-7272",
            "fax_number": "281-480-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 BAY AREA BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770581521",
            "telephone_number": "281-480-7272",
            "fax_number": "281-480-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON INSTITUTE OF DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "BERTHELOT",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "281-480-7272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M7042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.