Phillip M Ecker, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

47896 Issued in MN

Practice address

1905 Wayzata Blvd Ste 240
Wayzata, MN 55391-5006

Phone

(952) 222-8149

Fax

(262) 240-6257

NPI assigned

Dec 28, 2005

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

Medicare fee-for-service enrollment

Enrolled in MN

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

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

Stanford University School of Medicine, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Ecker Dermatology PAGroup PAC ID 3375995343, 2 clinicians

Tareen Dermatology PAGroup PAC ID 8123288156, 45 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pmecker@eckerderm.emadirect.md
• Direct secure messaging: philecker@tareenderm.emadirect.md

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

• Ecker Dermatology PA

  • Dermatology Physician
  • Wayzata, MN
  • NPI 1598538258
  Medicare reassignment Care Compare group NPD Authorized official
• Tareen Dermatology, P.a.

  • Dermatology Physician
  • Roseville, MN
  • NPI 1063782621
  Medicare reassignment Care Compare group
• Tareen Dermatology, PA

  • Non-Pharmacy Dispensing Site
  • Maplewood, MN
  • NPI 1851856504
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1851378020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 WAYZATA BLVD STE 240",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553915006",
            "telephone_number": "952-222-8149",
            "fax_number": "262-240-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 WAYZATA BLVD STE 240",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553915006",
            "telephone_number": "952-222-8149",
            "fax_number": "262-240-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKER",
        "first_name": "PHILLIP",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "47896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Daniel S. Tierney, LLC
• Lucas G Dueffert, P.T
• Duffey Black Counseling and Care Managment of Wayzata, LLC
• Ebenezer Management Services
• Ecker Dermatology PA
• Eden Pathways
• Eden Pathways
• Erin Edwards, PHD
• Kristin Marilyn Edwards, CMT
• Nancy Kuhl Edwards, LICSW

• Dermatology Physician in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Dermatology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.