Abilene Dermatology and Skin Surgery Center PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ABILENE DERMATOLOGY AND SKIN SURGERY CENTER PC

Practice address

3190 Antilley Rd
Abilene, TX 79606-5006

Phone

(325) 672-5603

Fax

(325) 672-6570

NPI assigned

Nov 2, 2007

Last updated

Nov 15, 2023By 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

Dr. Sina Aboutalebi, MDNPI 1932391232

Title

Vice President

Phone

(325) 672-5603

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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, and the practitioner matching its NPPES authorized official.

• Sina Aboutalebi, M.D.

  • Dermatology Physician
  • Abilene, TX
  • NPI 1932391232
  Medicare reassignment Care Compare group NPD Authorized official
• Julie Ann Carroll, FNP

  • Family Nurse Practitioner
  • Abilene, TX
  • NPI 1316601628
  Medicare reassignment Care Compare group NPD
• Kleesy L Thomas, MD

  • Dermatology Physician
  • Abilene, TX
  • NPI 1487032462
  Medicare reassignment Care Compare group NPD
• Morgan Nicole Carroll, PA-C

  • Medical Physician Assistant
  • Abilene, TX
  • NPI 1447617543
  Medicare reassignment Care Compare group
• Kristen L. Martinez, PA-C

  • Physician Assistant
  • Abilene, TX
  • NPI 1225495914
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1962681304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3190 ANTILLEY ROAD",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065015",
            "telephone_number": "325-672-5603",
            "fax_number": "325-672-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 ANTILLEY RD",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065006",
            "telephone_number": "325-672-5603",
            "fax_number": "325-672-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABILENE DERMATOLOGY AND SKIN SURGERY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "ABOUTALEBI",
        "authorized_official_first_name": "SINA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "325-672-5603",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "0087QH",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG5724",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abilene Chiropractic PC (Abilene Chiropractic)
• Abilene Christian University (Center for Speech and Language Disorders at ACU)
• Abilene Christian University (ACU Sports Medicine)
• Abilene Christian University
• Abilene Dental Care South PLLC
• Abilene Emergency Physicians Staffing PA
• Abilene Endocrinology, P.a.
• Abilene Endodontics, PC
• Abilene Eye ASC LP (Abilene Cataract and Refractive Surgery Center)
• Abilene Eye Care, Inc.

• Dermatology Physician in Abilene, TX
• Providers in Abilene, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.