Dermatopatholoty Northwest PLLC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

50D0629327 Issued in WA

Legal business name

DERMATOPATHOLOTY NORTHWEST PLLC

Doing business as

Carlsen Histopath

Practice address

2330 130TH Ave NE # 201
Bellevue, WA 98005-1756

Phone

(425) 455-9945

Fax

(425) 455-9947

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Stacey P Murdoch

Title

Office Manager

Phone

(425) 455-9945

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Carlsen Histopath Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 5

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

• Kyle Justin Garton, MD

  • Dermatopathology Physician
  • Bellevue, WA
  • NPI 1578673372
  Medicare reassignment Care Compare group NPD
• Dan M Lantz, M.D.

  • Dermatology Physician
  • Bellevue, WA
  • NPI 1811082993

  Dermatopathology

  Medicare reassignment Care Compare group NPD
• Caitlin J May, M.D.

  • Dermatopathology Physician
  • Bellevue, WA
  • NPI 1215370630
  Medicare reassignment Care Compare group NPD
• Michael W. Piepkorn, M.D.

  • Dermatopathology Physician
  • Bellevue, WA
  • NPI 1609975226
  Medicare reassignment Care Compare group NPD
• John Stuart Walsh, M.D.

  • Dermatology Physician
  • Bellevue, WA
  • NPI 1942298161

  Dermatopathology

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1932296092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 130TH AVE NE # 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051756",
            "telephone_number": "425-455-9945",
            "fax_number": "425-455-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 130TH AVE NE # 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051756",
            "telephone_number": "425-455-9945",
            "fax_number": "425-455-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOPATHOLOTY NORTHWEST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "MURDOCH",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-455-9945"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "WA",
            "license": "50D0629327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "6337DE",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7099864",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carlsen Histopath",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Travis Depew, PT, DPT
• Kam Derakshani, DDS
• Julie Deramo, LMP
• Tatjana Deretic, M.D.
• Dermatology Arts, PLLC (Dermatology Arts)
• Jessica Laura Deroche, LMT
• Eric Derovanessian, D.D.S
• Nicolaas Piet Deruyter, MD
• Arzu Dervish
• Vicki A Deshazo

• Dermatopathology Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Dermatopathology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.