Organization Active NPI

Skin Cancer Center, PLLC

  • MOHS-Micrographic Surgery Physician
  • Norman, OK
National Provider Identifier
1962061440
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
SKIN CANCER CENTER, PLLC
Practice address
3209 24TH Ave NW
Norman, OK 73069-6738
Phone
(405) 865-4040
Fax
(405) 865-4041
NPI assigned
Jun 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
Benjamin BigbieNPI 1104262526
Title
Member
Phone
(405) 865-4040

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X Primary

Addresses

Primary practice location

3209 24TH Ave NW
Norman, OK 73069-6738

Mailing address

PO Box 720067
Norman, OK 73070-4051
Phone (405) 865-4040

Other identifiers 1

IdentifierTypeStateIssuer
1104262526MedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190705000277 OK Part B Supplier - Clinic/Group Practice 7719212240 Receives reassigned benefits from 2 practitioners
Practice locations: Norman, OK

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
37D2170367Skin Cancer Center, PLLC3209 24TH Ave NW, Norman, OK 73069ComplianceMar 28, 2027

National Provider Directory

National Provider Directory

Locations

3209 24th Ave NW
Norman, OK 73069
Phone (405) 701-9089

Practitioners & affiliated clinicians

Practitioners 2

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": "1560124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1962061440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720067",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730704051",
            "telephone_number": "405-865-4040",
            "fax_number": "405-865-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 24TH AVE NW",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696738",
            "telephone_number": "405-865-4040",
            "fax_number": "405-865-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CANCER CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-10",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "BIGBIE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "405-865-4040"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104262526",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.