Organization Active NPI

R&R Dermatology Services PLLC

  • Dermatology Physician
  • Oklahoma City, OK
National Provider Identifier
1831714658
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
R&R DERMATOLOGY SERVICES PLLC
Practice address
13301 N Meridian Ave Ste 201
Oklahoma City, OK 73120-8381
Phone
(405) 803-8020
Fax
(405) 437-2332
NPI assigned
Jun 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Authorized official

Name
Dr. Stacie E Rougas, MDNPI 1194793430
Title
Owner
Phone
(405) 803-8020

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

13301 N Meridian Ave Ste 201
Oklahoma City, OK 73120-8381

Mailing address

PO Box 54333
Oklahoma City, OK 73154-1333
Phone (405) 803-8020

Other names 1

  • Dermatology and aesthetics of oklahoma Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200828000545 OK Part B Supplier - Clinic/Group Practice 1658798103 Receives reassigned benefits from 8 practitioners
Practice locations: Oklahoma City, OK; Edmond, OK

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
37D2187199Dermatology and Aesthetics of Oklahoma13301 N Meridian Avenue, Oklahoma City, OK 73120Provider-performed microscopyJun 25, 2028

National Provider Directory

National Provider Directory

Locations

3863 S Boulevard
Ste 200
Edmond, OK 73013
Phone (405) 216-5444

3863 S Boulevard
Edmond, OK 73013
Phone (405) 216-5444

4101 NW 122nd St
Oklahoma City, OK 73120
Phone (405) 562-9260

4101 NW 122nd St
Ste C
Oklahoma City, OK 73120
Phone (405) 562-9260

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1831714658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54333",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731541333",
            "telephone_number": "405-803-8020",
            "fax_number": "405-437-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13301 N MERIDIAN AVE STE 201",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208381",
            "telephone_number": "405-803-8020",
            "fax_number": "405-437-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R&R DERMATOLOGY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "ROUGAS",
        "authorized_official_first_name": "STACIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-803-8020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology and aesthetics of oklahoma",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dermatology and aesthetics of oklahoma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.