NPI Details
Joan M Griner Licht, MD is a procedural dermatology dermatology in Traverse City, MI with 36 years of experience. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). Joan M Griner Licht, MD NPI is 1710902945. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1990
The provider's business location address is:
3643 W FRONT ST STE A
TRAVERSE CITY, MI
ZIP 49684-760
Phone: (231) 935-0620
Fax: (231) 935-0626
The NPI 1710902945 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.
- Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
- Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
- Destruction of precancer skin growth, 1 growth (HCPCS:17000)
- Destruction of skin growth, 1-14 growths (HCPCS:17110)
- New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
- Biopsy of related skin growth, first growth (HCPCS:11102)
- Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
- Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm (HCPCS:17261)
- Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm (HCPCS:17262)
- Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
- Punch biopsy, first skin growth (HCPCS:11104)
- Melanoma (skin cancer) excision (HCPCS:NAN03)
The enumeration date for this NPI number is 7/12/2006 and was last updated on 10/21/2014.
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 Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207NS0135X | Dermatology | Procedural Dermatology | JG058054 | MICHIGAN | Yes |
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 Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | F85530 | MEDICARE UPIN | MICHIGAN | |
