Dermatology Surgical & Medical Group

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY SURGICAL & MEDICAL GROUP

Practice address

1661 Soquel Dr
Building E
Santa Cruz, CA 95065

Phone

(831) 476-2444

Fax

(831) 476-3271

NPI assigned

Sep 20, 2006

Last updated

Jun 26, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diana Niles

Title

Office Manager

Phone

(831) 476-2444

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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.

• Andrew Spedding Calciano, MD

  • Dermatology Physician
  • Santa Cruz, CA
  • NPI 1942201702
  NPD
• Morgan Lawrence Magid, MD

  • Dermatology Physician
  • Santa Cruz, CA
  • NPI 1417958273
  NPD
• Molly Courtwright Shields, MD

  • Dermatology Physician
  • Santa Cruz, CA
  • NPI 1952302556
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1962509109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 SOQUEL DR",
            "address_2": "BUILDING E",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651709",
            "telephone_number": "831-476-2444",
            "fax_number": "831-476-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 SOQUEL DR",
            "address_2": "BUILDING E",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "95065",
            "telephone_number": "831-476-2444",
            "fax_number": "831-476-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SURGICAL & MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "NILES",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "831-476-2444"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0053090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmanuel John Denike
• Denisse Gomez, DMD, Inc.
• Sophie Leanne Densham
• Lee Denton
• James Lloyd Depuy Jr., JAMES DEPUY
• Isha Desai
• Kirtikumar Gopalji Desai, MD
• CJ Desbouillons
• Beverly Gail Deschaux, MFT
• Angelika Desimone

• Dermatology Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.