Individual provider Active NPI

Daren Alexander Fomin, DO

  • MOHS-Micrographic Surgery Physician
  • Anderson, SC
National Provider Identifier
1982132510
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
91371 Issued in SC
Practice address
1409 N Fant St
Anderson, SC 29621-4825
Phone
(864) 231-8599
Fax
(864) 231-8073
NPI assigned
May 26, 2017
Last updated
May 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 91371 SC Primary
Dermatology Physician 207N00000X 05-44847 KS
Dermatology Physician 207N00000X 0102205409 VA

Addresses

Primary practice location

1409 N Fant St
Anderson, SC 29621-4825

Mailing address

1409 N Fant St
Anderson, SC 29621-4825
Phone (864) 231-8599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250324001080 SC Practitioner - Dermatology 1254732993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Campbell Univ School of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Skin and SurgeryGroup PAC ID 0941244065, 4 clinicians

Practice addresses (Care Compare)

1409 N Fant St
Anderson, SC 29621-4825
Phone (864) 231-8599

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Promoting interoperability
90
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
80.11
Promoting interoperability
97
Improvement activities
40
Cost
72.09

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision568
Removal of tissue25
Removal of skin lesions271
Removal of skin cancer1558
Removal of nail tissue1-10
Removal or shaving of skin growth19
Skin biopsy244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102205409VAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Skin & Surgery Mohs-Micrographic Surgery CurrentSince Apr 1, 2025 Accepting new patients
Scott E Manthei PC LTD Past Accepting new patients
Paragon Skin & Surgery, PA PastSince Apr 1, 2025 Accepting new patients

Locations

1409 N Fant St
Anderson, SC 29621
Phone (864) 231-8599

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1982132510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214825",
            "telephone_number": "864-231-8599",
            "fax_number": "864-231-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214825",
            "telephone_number": "864-231-8599",
            "fax_number": "864-231-8073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOMIN",
        "first_name": "DAREN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-26",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "SC",
            "license": "91371",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "05-44847",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0102205409",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.