Advanced Dermatology & Cosmetic Institute P.a.
Organization Active NPI Dermatology Physician · Edina, MN
NPI 1992890917 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1992890917
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- MN28680 (MN)
- Legal business name
- ADVANCED DERMATOLOGY & COSMETIC INSTITUTE P.A.
- Practice address
- 6525 Barrie Rd
Edina, MN 55435-2305 - Phone
- (952) 915-6000
- Fax
- (952) 915-6100
- NPI assigned
- Oct 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Marie Elizabeth Briden, MD
- Title
- Ceo/Medical Director
- Phone
- (952) 915-6000
Practitioners 3
-
Denise L. Barnhardt, P.A.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041123001047 | MN | Part B Supplier - Clinic/Group Practice | 4880659358 |
Receives reassigned benefits from 3 practitioners Practice locations: Edina, MN; Shakopee, MN; Waconia, MN |
National Provider Directory
Locations
6525 Barrie Rd
Minneapolis, MN 55435
Phone (952) 915-6000
1515 Saint Francis Ave
Ste 145
Shakopee, MN 55379
Phone (952) 241-5873
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | MN28680 | MN | Yes |
Addresses
Primary practice location
6525 Barrie Rd
Edina, MN 55435-2305
Mailing address
6525 Barrie Rd
Edina, MN 55435-2305
Phone (952) 915-6000
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All providers in Edina, MN · Dermatology Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.