Carlisle Dermatology Group

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

OS17070 Issued in PA

Legal business name

CARLISLE DERMATOLOGY GROUP

Practice address

19 Sprint Drive
Suite 1
Carlisle, PA 17015-7002

Phone

(717) 701-8251

Fax

(717) 701-8289

NPI assigned

Aug 24, 2014

Organization subpart

No

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

Authorized official

Name

Julian Map Ngo, D.O.NPI 1689989675

Title

Owner/President

Phone

(717) 701-8251

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 4

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

• Julian M. Ngo, D.O.

  • MOHS-Micrographic Surgery Physician
  • Carlisle, PA
  • NPI 1689989675
  Medicare reassignment Care Compare group NPD Authorized official
• Amanda Joan Greb, PA-C

  • Physician Assistant
  • Carlisle, PA
  • NPI 1376201087
  Medicare reassignment Care Compare group
• Jessica Schaffer Rein, PA-C

  • Medical Physician Assistant
  • Carlisle, PA
  • NPI 1710964861
  Medicare reassignment Care Compare group
• Leah Anne Reitzi, PA-C

  • Medical Physician Assistant
  • Carlisle, PA
  • NPI 1245777192
  Medicare reassignment

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

{
    "created_epoch": "1408838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1962802249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SPRINT DRIVE",
            "address_2": "SUITE 1",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170157002",
            "telephone_number": "717-701-8251",
            "fax_number": "717-701-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 SPRINT DRIVE",
            "address_2": "SUITE 1",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170157002",
            "telephone_number": "717-701-8251",
            "fax_number": "717-701-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLISLE DERMATOLOGY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-24",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "NGO",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_middle_name": "MAP",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "717-701-8251",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "PA",
            "license": "OS17070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlisle Area School District
• Carlisle Cardiology Associates, PC
• Carlisle Dental Care PC
• Carlisle Dental Studio P.C.
• Carlisle Dermatology Associates, P.C.
• Carlisle Digestive Disease Associates, LTD.
• Carlisle Ear Nose & Throat Associates
• Carlisle Endoscopy Center, LTD.
• Carlisle Hearing Center
• Carlisle Hma LLC

• MOHS-Micrographic Surgery Physician in Carlisle, PA
• Providers in Carlisle, PA by specialty
• MOHS-Micrographic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.