NPIMap

Organization Active NPI

Skin Physicians PA

  • Dermatology Physician
  • Eden Prairie, MN
National Provider Identifier
1780795997
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
1178 Issued in MN
Legal business name
SKIN PHYSICIANS PA
Practice address
11800 Singletree Lane
Suite 205
Eden Prairie, MN 55344
Phone
(952) 829-5881
Fax
(952) 829-1754
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Scott M Ross, MD
Title
President
Phone
(952) 829-5881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 1178 MN Primary

Addresses

Primary practice location

11800 Singletree Lane
Suite 205
Eden Prairie, MN 55344

Mailing address

11800 Singletree Lane
Suite 205
Eden Prairie, MN 55344
Phone (952) 829-5881

National Provider Directory

National Provider Directory

Locations

11800 Singletree Ln
Ste 205
Eden Prairie, MN 55344
Phone (952) 829-5881

19950 Dodd Blvd
Ste 102
Lakeville, MN 55044
Phone (612) 920-7546

3916 W 50th St
Minneapolis, MN 55424
Phone (612) 920-7546

Practitioners & affiliated clinicians

Practitioners 11

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780795997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 SINGLETREE LANE",
            "address_2": "SUITE 205",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "952-829-5881",
            "fax_number": "952-829-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 SINGLETREE LANE",
            "address_2": "SUITE 205",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "952-829-5881",
            "fax_number": "952-829-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-829-5881",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "MN",
            "license": "1178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.