Skin Joy Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

Q5053 Issued in TX

Legal business name

SKIN JOY DERMATOLOGY PLLC

Practice address

9015 Mountain Ridge Dr.
Suite 200
Austin, TX 78759-7303

Phone

(512) 312-7552

Fax

(512) 714-4786

NPI assigned

Apr 11, 2018

Organization subpart

No

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

Authorized official

Name

Olubusayo K Obayan, M.D.NPI 1740573997

Title

Owner

Phone

(512) 312-7552

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Olubusayo Obayan, M.D., MPH

  • Dermatology Physician
  • Austin, TX
  • NPI 1740573997
  Medicare reassignment NPD Authorized official
• Nadia Esmaeili, PA

  • Physician Assistant
  • Katy, TX
  • NPI 1336669910
  Medicare reassignment
• Jo Yana Vendl, PSY.D.

  • Clinical Psychologist
  • Austin, TX
  • NPI 1184974669
  NPD (past)

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1972000321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9015 MOUNTAIN RIDGE DR.",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787597303",
            "telephone_number": "512-312-7552",
            "fax_number": "512-714-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 MOUNTAIN RIDGE DR.",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787597303",
            "telephone_number": "512-312-7552",
            "fax_number": "512-714-4786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN JOY DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "OBAYAN",
        "authorized_official_first_name": "OLUBUSAYO",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-312-7552",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TX",
            "license": "Q5053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "Q5053",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "Q5053",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Veda Skelton
• Andrew Leonard Skiles, MD
• Kelly Skiles, PA
• Amanda Skillern, M.D.
• Stephanie Ann Skillern
• Julia Devier-Scott Skinner, PT, DPT
• Leanne Skinner, R.D.,L.D.
• Robert A. Skjonsby, MD
• Daniel Neil Skoglund, M.D.
• Ella Jane Skoler, DMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.