Macinnis Dermatology

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME100399 Issued in FL

Legal business name

MACINNIS DERMATOLOGY

Practice address

27950 US Highway 27
Leesburg, FL 34748-9050

Phone

(352) 350-5230

Fax

(866) 539-7193

NPI assigned

Jan 4, 2010

Last updated

Mar 17, 2018By 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

Colleen Macinnis, M.D.NPI 1700828290

Title

Owner

Phone

(352) 350-5230

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

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.

• Colleen Renee Macinnis, MD

  • Dermatology Physician
  • Leesburg, FL
  • NPI 1700828290

  Mohs-Micrographic Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Chris L Narsesian, NP

  • Family Nurse Practitioner
  • Leesburg, FL
  • NPI 1073159513
  Medicare reassignment Care Compare group NPD
• Shana R. Schroeder, DO

  • Dermatology Physician
  • Leesburg, FL
  • NPI 1790056711
  Medicare reassignment Care Compare group NPD
• George Edwin Vonhilsheimer IV, M.D.

  • Dermatology Physician
  • The Villages, FL
  • NPI 1063519254

  Mohs-Micrographic Surgery

  Medicare reassignment Care Compare group NPD
• Amy M Goetz, PA-C

  • Surgical Physician Assistant
  • The Villages, FL
  • NPI 1962598367
  Medicare reassignment Care Compare group
• Tonya M Terwilliger, PA-C

  • Physician Assistant
  • Leesburg, FL
  • NPI 1639258072
  Medicare reassignment Care Compare group
• Sarah Katherine Yoho, PA-C

  • Physician Assistant
  • Mount Dora, FL
  • NPI 1487919171
  Medicare reassignment Care Compare group
• Alecia Shantel Folkes, DO

  • Dermatology Physician
  • Mount Dora, FL
  • NPI 1811358633
  NPD

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1992035695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490558",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347490558",
            "telephone_number": "352-350-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27950 US HIGHWAY 27",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347489050",
            "telephone_number": "352-350-5230",
            "fax_number": "866-539-7193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17521 US Highway 27",
            "address_2": "Suite 21",
            "address_purpose": "LOCATION",
            "city": "Mt Dora",
            "state": "FL",
            "postal_code": "327573275",
            "country_code": "US",
            "telephone_number": "352-350-5230",
            "fax_number": "352-350-5230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1950 Laurel Manor Dr Ste 124",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321625602",
            "country_code": "US",
            "telephone_number": "352-350-5230",
            "fax_number": "866-539-7193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4120 Corley Island Rd",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347488292",
            "country_code": "US",
            "telephone_number": "352-350-5230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4120 Corley Island Rd",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347488292",
            "country_code": "US",
            "telephone_number": "352-350-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MACINNIS DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MACINNIS",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-350-5230",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME100399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• M & M Rehab., Inc. (Mid-Florida Prosthetics & Orthotics)
• Francis Yuri Maccedo, MD
• Andrea M Macdonald, ARNP
• Colleen Renee Macinnis, MD
• Amy Mack, APRN
• Patricia Mack, BA
• Bonni Lynn Macqueen, APN
• Macrodont Solutions Inc (Sunrise Dental)

• MOHS-Micrographic Surgery Physician in Leesburg, FL
• Providers in Leesburg, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.