Skin Care Doctors, P.a.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

SKIN CARE DOCTORS, P.A.

Practice address

14000 Nicollet Ave Ste 304
Burnsville, MN 55337-5784

Phone

(952) 898-1600

Fax

(952) 898-2645

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Ebertz, M.D.NPI 1144386392

Title

President

Phone

(952) 898-1600

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN

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

Practitioners 16

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

• Kristin Joy Anderson, FNP

  • Nurse Practitioner
  • Burnsville, MN
  • NPI 1225662174
  Medicare reassignment Care Compare group NPD
• Michael John Ebertz, M.D.

  • Dermatology Physician
  • Burnsville, MN
  • NPI 1144386392
  Medicare reassignment NPD Authorized official
• Heidi Leigh Foster, M.D.

  • Dermatology Physician
  • Orono, MN
  • NPI 1790841989
  Medicare reassignment Care Compare group NPD
• Lawrence Lazelle Anderson, MD

  • Dermatology Physician
  • Tyler, TX
  • NPI 1134159627

  MN

  Medicare reassignment Care Compare group NPD
• Nadine Miller

  • Medical Physician Assistant
  • Minneapolis, MN
  • NPI 1811929870
  Medicare reassignment Care Compare group
• Anastasios Angelo Pappas, M.D.

  • Dermatology Physician
  • Saint Paul, MN
  • NPI 1912904970
  Medicare reassignment Care Compare group
• Margareth Pierre-Louis, MD

  • Dermatology Physician
  • Minneapolis, MN
  • NPI 1063731065
  Medicare reassignment Care Compare group
• Hazel Rogers, PA-C

  • Physician Assistant
  • Sartell, MN
  • NPI 1083368856
  Medicare reassignment Care Compare group
• Matthew William Morrissey, MD

  • Dermatology Physician
  • Burnsville, MN
  • NPI 1235403916
  Medicare reassignment NPD
• Avi Bitterman

  • Dermatopathology Physician
  • Woodmere, NY
  • NPI 1851755490

  MN

  Medicare reassignment NPD
• Jeffrey Neil Samuelson, M.D.

  • MOHS-Micrographic Surgery Physician
  • Duluth, MN
  • NPI 1407912678
  NPD
• Tracy Ann Seel, PA

  • Physician Assistant
  • Garden City, UT
  • NPI 1326043225
  NPD

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1851516397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 NICOLLET AVE STE 304",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375784",
            "telephone_number": "952-898-1600",
            "fax_number": "952-898-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 NICOLLET AVE STE 304",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375784",
            "telephone_number": "952-898-1600",
            "fax_number": "952-898-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CARE DOCTORS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "EBERTZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-898-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C02848",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH6529",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "57238",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "E180",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09G0SK",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Makayla Skipper
• Emily Skjeveland
• Ryan Thomas Skrenes, DC
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• Medical Specialty Clinic/Center in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Medical Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.