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ADVANCED DERMATOLOGIC SURGERY P.A. NPI 1003016312


NPI Information

NPI: 1003016312
Provider Name: ADVANCED DERMATOLOGIC SURGERY, P.A.

Doing Business As: ADVANCED DERMATOLOGIC SURGERY

Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 17D0890923

Address:
6901 W 121ST ST
OVERLAND PARK, KS
ZIP 66209
Phone: (913) 661-1755
Get Directions

ADVANCED DERMATOLOGIC SURGERY, P.A. is a mohs-micrographic surgery dermatology in Overland Park, KS. 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. ADVANCED DERMATOLOGIC SURGERY, P.A. NPI is 1003016312. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Advanced Dermatologic Surgery.

The provider's business location address is:

6901 W 121ST ST
OVERLAND PARK, KS
ZIP 66209-007
Phone: (913) 661-1755
Fax: (913) 661-9260

The provider's authorized official is Greg Albers .
The authorized official title is Cfo and has the following contact phone number (913) 661-1755.

The CLIA number assigned to this NPI record is 17D0890923 - ambulatory surgery center with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/24/2007 and was last updated on 6/3/2022.


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
1174400000XSpecialist04-25136KANSASNo
2291U00000XClinical Medical Laboratory04-25136KANSASNo
3207ND0101XDermatologyMOHS-Micrographic SurgeryYes

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
117D0890923OTHERCLIA #

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: 4/28/2024

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