Organization Active NPI

Cincinnati Dermatology Center, LLC

  • Dermatology Physician
  • Cincinnati, OH
National Provider Identifier
1942336110
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35081463F Issued in OH
Legal business name
CINCINNATI DERMATOLOGY CENTER, LLC
Practice address
7730 Montgomery Rd
Suite 200
Cincinnati, OH 45236-4283
Phone
(513) 984-4800
NPI assigned
Feb 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Authorized official

Name
Dr. Mona Salem Foad, MDNPI 1316011661
Title
Ceo
Phone
(513) 984-4800

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 35081463F OH Primary

Addresses

Primary practice location

7730 Montgomery Rd
Suite 200
Cincinnati, OH 45236-4283

Mailing address

7730 Montgomery Rd
Suite 200
Cincinnati, OH 45236-4283
Phone (513) 984-4800

Other identifiers 1

IdentifierTypeStateIssuer
2345804MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160308001375 OH Part B Supplier - Clinic/Group Practice 3577662998 Receives reassigned benefits from 7 practitioners
Practice locations: Cincinnati, OH

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
36D1068281Cincinnati Dermatology Center7730 Montgomery Road Suite 200, Cincinnati, OH 45236ComplianceMay 13, 2027

National Provider Directory

National Provider Directory

Locations

7730 Montgomery Rd
Cincinnati, OH 45236
Phone (513) 791-9959

7730 Montgomery Rd
Fl 2
Cincinnati, OH 45236

Practitioners & affiliated clinicians

Practitioners 9

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": "1172275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1942336110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 MONTGOMERY RD",
            "address_2": "SUITE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452364283",
            "telephone_number": "513-984-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 MONTGOMERY RD",
            "address_2": "SUITE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452364283",
            "telephone_number": "513-984-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CINCINNATI DERMATOLOGY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-24",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "FOAD",
        "authorized_official_first_name": "MONA",
        "authorized_official_middle_name": "SALEM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "513-984-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35081463F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2345804",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.