Advanced Dermatology and Skin Surgery Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A97430 Issued in CA

Legal business name

ADVANCED DERMATOLOGY AND SKIN SURGERY INC

Doing business as

Advanced Dermatology & Skin Surgery of Northern California

Practice address

4155 Moorpark Ave Ste 3
San Jose, CA 95117-1714

Phone

(586) 344-1624

Fax

(408) 493-6782

NPI assigned

Mar 17, 2010

Last updated

Mar 7, 2023By 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. George C. F. Hsieh, M.D.NPI 1437296399

Title

Owner

Phone

(586) 344-1624

Specialties & licenses 1

Addresses

Other names 1

• Advanced Dermatology & Skin Surgery of Northern California Doing business as

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

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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.

• George C. Hsieh, MD, FAAD

  • Dermatology Physician
  • Los Gatos, CA
  • NPI 1437296399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1821312091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 MOORPARK AVE STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171714",
            "telephone_number": "586-344-1624",
            "fax_number": "408-493-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 MOORPARK AVE STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171714",
            "telephone_number": "586-344-1624",
            "fax_number": "408-493-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY AND SKIN SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "HSIEH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "C. F.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-344-1624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A97430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology & Skin Surgery of Northern California",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.