Organization Active NPI

Carmelo Plateroti, D.O., a Professional Corporation

Doing business as Dermatology Associates of the North County

  • MOHS-Micrographic Surgery Physician
  • Templeton, CA
National Provider Identifier
1902095847
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
20A6201 Issued in CA
Legal business name
CARMELO PLATEROTI, D.O., A PROFESSIONAL CORPORATION
Doing business as
Dermatology Associates of the North County
Practice address
1101 Las Tablas Rd Ste G
Templeton, CA 93465-9731
Phone
(805) 434-2821
Fax
(805) 434-2526
NPI assigned
Oct 16, 2007
Last updated
Apr 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Authorized official

Name
Carmelo A. Plateroti, D.O.NPI 1275556029
Title
Director
Phone
(805) 434-2821

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
MOHS-Micrographic Surgery Physician 207ND0101X 20A6201 CA Primary

Addresses

Primary practice location

1101 Las Tablas Rd Ste G
Templeton, CA 93465-9731

Mailing address

1101 Las Tablas Rd Ste G
Templeton, CA 93465-9731
Phone (805) 434-2821

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ44336ZOtherCABLUE SHIELD

Other names 1

  • Dermatology Associates of the North County Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140304000185 CA Part B Supplier - Clinic/Group Practice 7810127255 Receives reassigned benefits from 4 practitioners
Practice locations: Templeton, CA

National Provider Directory

National Provider Directory

Locations

1111 Las Tablas Rd
Ste M
Templeton, CA 93465
Phone (805) 434-2821

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1902095847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 LAS TABLAS RD STE G",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659731",
            "telephone_number": "805-434-2821",
            "fax_number": "805-434-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 LAS TABLAS RD STE G",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659731",
            "telephone_number": "805-434-2821",
            "fax_number": "805-434-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMELO PLATEROTI, D.O., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "PLATEROTI",
        "authorized_official_first_name": "CARMELO",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "805-434-2821",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "20A6201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ44336Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates of the North County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Templeton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.