Charles Russell Kovaleski, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME36420 Issued in FL

Practice address

1900 Harrison Ave
Panama City, FL 32405-4542

Phone

(850) 769-1668

Fax

(850) 785-2123

NPI assigned

Dec 7, 2005

Last updated

May 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Florida College of Medicine, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates of Bay County PAGroup PAC ID 5799800322, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.48 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

91.61

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckovaleskimd@769skin.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatology Associates of Bay County, P.a.

  • Dermatology Physician
  • Panama City, FL
  • NPI 1215904404
  Medicare reassignment Care Compare group
• Dermatology Associates, PA

  • Dermatology Physician
  • Chipley, FL
  • NPI 1164740809
  NPD

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1811972391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-769-1668",
            "fax_number": "850-785-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 HARRISON AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054542",
            "telephone_number": "850-769-1668",
            "fax_number": "850-785-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALESKI",
        "first_name": "CHARLES",
        "middle_name": "RUSSELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME36420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039443200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "99500",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia R Knighten, RPH
• Neda C Koehnemann, PHD
• Inna Kogan, MD
• Christie Konen, APRN
• Shardul Koppar, D.O.
• Lauren Kovaleski, DMD
• Deborah O Kranak, M.S., CCC
• Jorey Krawczyn, IMH2565
• Martin Kreslin, LMT, NMT
• Wendy D Kriegel, M.D.

• Dermatology Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.