1. Home
  2. Directory
  3. California
  4. Novato
  5. Dermatology
  6. NPI Profile

NOVATO DERMATOLOGY ASSOCIATES A MEDICAL CORPORATION
NPI 1003960063
Dermatology in Novato, CA

Active since January 23, 2007
867 DIABLO AVE, NOVATO, CA 94947(415) 892-0754(415) 897-3204 Get Directions Write a Review

NPPES record last updated: November 8, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Novato Dermatology Associates A Medical Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOVATO DERMATOLOGY ASSOCIATES A MEDICAL CORPORATION (NPI 1003960063) is a healthcare organization registered as a dermatology in Novato, California and active in the NPI registry since January 2007. The organization lists Kim S Frederickson, Owner, as its authorized official.

NPPES Registry Identity

NPI1003960063
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameNOVATO DERMATOLOGY ASSOCIATES A MEDICAL CORPORATION
Location Address867 DIABLO AVENovato, CA 94947-4007
Mailing Address867 Diablo AveNovato, CA 94947-4007 · (415) 892-0754 · Fax (415) 897-3204
Phone(415) 892-0754
Fax(415) 897-3204
Organization SubpartNo
Authorized OfficialKim S FredericksonOwner · (415) 892-0754
Enumeration DateJanuary 23, 2007
Last NPPES UpdateNovember 8, 2018
✔ NPI 1003960063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CA · G79619
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
867 DIABLO AVE, Novato, CA 94947
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Novato Dermatology Associates A Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Novato Dermatology Associates A Medical Corporation, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Stephen Dalton, M.D.
Dermatology
NPI 1053318824
400 PROFESSIONAL CENTER DR SUITE 414
Novato, CA 94947
(415) 892-0754
✔ PECOS✔ Accepts Medicare0.5 mi
Kim Frederickson, MD
Dermatology
NPI 1003995291
400 PROFESSIONAL CENTER DRIVE SUITE 414 NOVATO DERMATOLOGY ASSOCIATES
Novato, CA 94947
(415) 892-0754
✔ PECOS✔ Accepts Medicare0.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Novato Dermatology Associates A Medical Corporation's NPI number?

The NPI number for Novato Dermatology Associates A Medical Corporation is 1003960063. It was assigned to this organization in the NPPES registry on January 23, 2007.

Where is Novato Dermatology Associates A Medical Corporation located?

Novato Dermatology Associates A Medical Corporation is located at 867 Diablo Ave, Novato, CA 94947. The listed phone number is (415) 892-0754.

What is Novato Dermatology Associates A Medical Corporation's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Novato Dermatology Associates A Medical Corporation enrolled in Medicare?

Yes. Novato Dermatology Associates A Medical Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Novato Dermatology Associates A Medical Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Novato Dermatology Associates A Medical Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Novato Dermatology Associates A Medical Corporation was last updated on November 8, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.