Provider Type Icon

JACK FOSTER DITTY M.D. NPI 1740315589


NPI Information

NPI: 1740315589
Provider Name: JACK FOSTER DITTY, M.D.
Classification: Dermatology - 207ND0101X
Entity Type: Individual

Specialization: MOHS-Micrographic Surgery

PECOS Registration: Yes

CLIA Number: 18D0324678

Address:
100 SAINT CHRISTOPHER DR
ASHLAND, KY
ZIP 41101
Phone: (606) 836-3111
Get Directions

Jack Foster Ditty, M.D. is a mohs-micrographic surgery dermatology in Ashland, KY with 49 years of experience. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. Jack Foster Ditty, M.D. NPI is 1740315589. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOUISVILLE MEDICAL COLLEGE
Graduation Year:1975

The provider's business location address is:

100 SAINT CHRISTOPHER DR
ASHLAND, KY
ZIP 41101-016
Phone: (606) 836-3111
Fax: (606) 833-5660

The NPI 1740315589 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 18D0324678 - physician office with a certificate type of Certificate of Compliance.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Pathology examination of tissue using a microscope, intermediate complexity (HCPCS:88305)
  • Biopsy of single growth of skin and/or tissue (HCPCS:11100)
  • Destruction of skin growth (HCPCS:17000)
  • Pathology examination of tissue using a microscope, moderately low complexity (HCPCS:88304)

The enumeration date for this NPI number is 2/22/2007 and was last updated on 4/21/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic Surgery20687KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C74177MEDICARE UPIN
2406073364MEDICARE ID-TYPE UNSPECIFIEDKENTUCKYRAIL ROAD MEDICARE
3611053554OTHERKENTUCKYTAX ID
4024 1170MEDICAIDOHIO
51304101MEDICARE ID-TYPE UNSPECIFIEDKENTUCKY
664206873MEDICAIDKENTUCKY
7AD9266823OTHERKENTUCKYDEA #
8000000048343OTHERKENTUCKYANTHEM PROVIDER #
920687OTHERKENTUCKYMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.