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DR. JEFFREY NEIL SAMUELSON M.D. NPI 1407912678


NPI Information

NPI: 1407912678
Provider Name: DR. JEFFREY NEIL SAMUELSON, M.D.
Classification: Dermatology - 207ND0101X
Entity Type: Individual

Specialization: MOHS-Micrographic Surgery

Organization: TWIN PORTS DERMATOLOGY INC

PECOS Registration: Yes

Address:
1414 WOODLAND AVE
DULUTH, MN
ZIP 55803
Phone: (218) 302-1000
Get Directions

DR. Jeffrey Neil Samuelson, M.D. is a mohs-micrographic surgery dermatology in Duluth, MN with 35 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. DR. Jeffrey Neil Samuelson, M.D. NPI is 1407912678. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: R FRANKLIN UNIVERSITY OF MED & SCI/CHICAGO MEDICAL SCHOOL
Graduation Year:1989

The provider's business location address is:

1414 WOODLAND AVE
DULUTH, MN
ZIP 55803-624
Phone: (218) 302-1000

The NPI 1407912678 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 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.

  • Destruction of 2-14 skin growths (HCPCS:17003)
  • Destruction of skin growth (HCPCS:17000)
  • Biopsy of single growth of skin and/or tissue (HCPCS:11100)
  • Repair of wound (2.6 to 7.5 centimeters) of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, and/or feet (HCPCS:13132)

The enumeration date for this NPI number is 12/29/2006 and was last updated on 10/13/2020.


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
1207N00000XDermatology40515MINNESOTANo
2207ND0101XDermatologyMOHS-Micrographic Surgery40515MINNESOTAYes

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
1860217400MEDICAIDMINNESOTA

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.