Dermaliz Pagan, SA-C

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

22-799 Issued in MD

Practice address

1740 Shotley Bridge Place
Olney, MD 20832-1734

Phone

(301) 363-4934

Fax

(301) 363-4934

NPI assigned

Jan 31, 2023

Last updated

Jan 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Platinum Surgical Assistants

  • Surgical Technologist
  • Fulton, MD
  • NPI 1962824896
  NPD (past)

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1982300174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3470 OLNEY LAYTONSVILLE RD STE 182",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321734",
            "telephone_number": "301-363-4934",
            "fax_number": "301-363-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 SHOTLEY BRIDGE PLACE",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321734",
            "telephone_number": "301-363-4934",
            "fax_number": "301-363-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGAN",
        "first_name": "DERMALIZ",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "MD",
            "license": "22-799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald David Oster, PH.D.
• Christopher Ovanez, MD, MPH, MS
• Onyinyechi Mavis Ozoji, RN
• Andrew Peter Padilla
• Divya Lakshmi Padmanabhan, DO
• Donald Jay Palmer, PH.D.
• Garsutis K. Palys, M.D.
• Melissa Paolino, PT
• Papilio, LLC
• Michele Parent, P.T.

• Surgical Assistant in Olney, MD
• Providers in Olney, MD by specialty
• Surgical Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.