ADVANCED DERMATOLOGIC SURGERY, P.A. NPI 1003016312
Dermatology - MOHS-Micrographic Surgery in Overland Park, KS
About ADVANCED DERMATOLOGIC SURGERY, P.A.
Advanced Dermatologic Surgery is a provider established in Overland Park, Kansas operating as a Dermatology with a focus in mohs-micrographic surgery . The NPI number of this provider is 1003016312 and was assigned on July 2007. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated one year ago. Advanced Dermatologic Surgery operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Advanced Dermatologic Surgery. The authorized official of this NPI record is Mr. Greg Albers Mpa (Cfo)
| NPI | 1003016312 |
| Provider Name | ADVANCED DERMATOLOGIC SURGERY, P.A. |
| Location Address | 6901 W 121ST ST OVERLAND PARK, KS 66209 |
| Location Phone | (913) 661-1755 |
| Mailing Address | 6901 W 121ST ST OVERLAND PARK, KS 66209 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Other Organization Name | ADVANCED DERMATOLOGIC SURGERY |
| Other Name Type | Doing Business As (3) |
| Enumeration Date | 07-24-2007 |
| Last Update Date | 06-03-2022 |
The CLIA number of Advanced Dermatologic Surgery is 17D0890923 registered as a "ambulatory surgery center" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued to Advanced Dermatologic Surgery after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 207ND0101X |
| Classification | Dermatology |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | MOHS-Micrographic Surgery |
| Taxonomy Description | 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. |
Accepted Insurance
The NPI profile data indicates this provider might be enrolled and accepting health plans from the following insurance companies or healthcare programs:
- Medicaid
- Medicare
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Business Address
6901 W 121ST ST
OVERLAND PARK, KS
ZIP 66209
Phone: (913) 661-1755
Fax: (913) 661-9260
Mailing Address
6901 W 121ST ST
OVERLAND PARK, KS
ZIP 66209
Phone: (913) 661-1755
Fax: (913) 661-9260
Secondary Locations
6410 N Cosby Ave
Kansas City, MO 64151
(816) 643-4501
Location Map
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003016312 is:
| CLIA Number | 17D0890923 |
| Facility Type | AMBULATORY SURGERY CENTER |
| Certificate Type | Certificate of Compliance |
Group Taxonomy
193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 174400000X | Other Service Providers | Specialist | 04-25136 | KS | No | |
Taxonomy Description: an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. | |||||||
| 2 | 291U00000X | Laboratories | Clinical Medical Laboratory | 04-25136 | KS | No | |
Taxonomy Description: (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 17D0890923 | OTHER (01) | CLIA # |
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 1 | 6 | 3 | 1 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 12 | 3 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 1 + 1 + 2 + 3 + 2 + 24 = 38 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 40 - 38 = 2 | 2 | ||||||||
The NPI number 1003016312 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1487659959 | DR. TIMOTHY L PARKER MD Individual | Dermatology (MOHS-Micrographic Surgery) | 6901 W 121ST ST OVERLAND PARK, KS 66209 (913) 661-1755 |
| 1649376757 | ADS HEALTHCARE LLC Organization | Clinic/Center (Ambulatory Surgical) | 6901 W 121ST ST OVERLAND PARK, KS 66209 (913) 661-1755 |
| 1689841025 | DR. THOMAS LEWIS HAMAGUCHI HOCKER M.D. Individual | Dermatology (MOHS-Micrographic Surgery) | 6901 W 121ST ST OVERLAND PARK, KS 66209 (913) 661-1755 |
| 1689036261 | ISADORE TARANTINO Individual | Dermatology | 6901 W 121ST ST OVERLAND PARK, KS 66209 (913) 661-1755 |
Frequently Asked Questions
What is ADVANCED DERMATOLOGIC SURGERY NPI number?
The NPI number assigned to this healthcare provider is 1003016312, registered as an "organization" on July 24, 2007
Where is ADVANCED DERMATOLOGIC SURGERY located?
The provider is located at 6901 W 121st St Overland Park, Ks 66209 and the phone number is (913) 661-1755
What kind of medical provider is ADVANCED DERMATOLOGIC SURGERY?
This medical organization specializes in Dermatology with a focus in MOHS-Micrographic Surgery
What insurance does ADVANCED DERMATOLOGIC SURGERY accept?
The provider might be accepting Medicaid and Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
What is ADVANCED DERMATOLOGIC SURGERY CLIA number?
The provider's CLIA number is 17D0890923 for a "ambulatory surgery center" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
How do I update my NPI information?
The NPI record of ADVANCED DERMATOLOGIC SURGERY was last updated on July 24, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
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