DR. MARY PATRICIA LIST MD
NPI 1013440874
Dermatology in Roseville, CA

Q: What is Mary List's NPI number?

The NPI number for Mary List is 1013440874. It was assigned to this individual provider in the NPPES registry on April 9, 2017.

Q: What is Mary List's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mary List was last updated on August 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since April 09, 2017PECOS EnrolledAccepts Medicare Assignment

92.53/100

CMS Quality Rating

2261 DOUGLAS BLVD, ROSEVILLE, CA 95661(916) 797-4766 Get Directions Write a Review

NPPES record last updated: August 22, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 16, 2023, Apr 9, 2020, Apr 10, 2019 (3 updates tracked since 2019).

On this page

About Dr. Mary Patricia List Md NPPES

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

DR. MARY PATRICIA LIST MD (NPI 1013440874) is an individual dermatology provider in Roseville, California, licensed in Ohio (35.148704) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1013440874

Entity TypeIndividualFemale

Primary Taxonomy207N00000X

Provider Legal NameDR. MARY PATRICIA LISTCredential: MD

Location Address2261 DOUGLAS BLVDRoseville, CA 95661-3831

Mailing AddressPo Box 255228Sacramento, CA 95865-5228 · (800) 470-0071

Phone(916) 797-4766

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateApril 9, 2017

Last NPPES UpdateAugust 22, 20253 updates tracked since enumeration

NPPES CertifiedAugust 22, 2025

✔ NPI 1013440874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in OH · 35.148704

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.

2261 DOUGLAS BLVD, Roseville, CA 95661

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Secondary Practice Locations 2

Location 17335 Yankee Rd Ste 202Liberty Township, OH 45044-1253 · Phone (513) 579-9191

Location 22139 Auburn AveCincinnati, OH 45219-2906 · Phone (513) 585-0855

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mary Patricia List Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294066999

PECOS Enrollment IDI20250820004774

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Mary List reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sutter Medical Foundation

13 mi

Diagnostic Radiology

2800 L ST FL 7
Sacramento, CA 95816

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Sutter Valley Medical Foundation
3,056 clinicians in this Medicare group

NPI 1942524095 (916) 731-7857

Christ Hospital Medical Specialists LLC

1,965 mi

Urology

2139 AUBURN AVE
Cincinnati, OH 45219

Reassigned Medicare billing, Ohio enrollment
187 clinicians in this Medicare group

NPI 1124341649 (513) 351-9900

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

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

413 services92 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

135 services121 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

112 services94 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

92 services83 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

86 services86 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

68 services61 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

58 services58 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

57 services55 patients

Biopsy of related skin growth, each additional growth 11103

A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.

21 services13 patients

Destruction of precancer skin growth, 15 or more growths 17004

This procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.

15 services14 patients

Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm 17262

This procedure involves removing a cancerous skin growth on the trunk, arms, or legs that is between 1.1 and 2.0 cm in size. The growth is destroyed using methods like surgery, laser, or freezing, aiming to eliminate cancer and prevent its spread.

15 services14 patients

Removal of skin tag, 1-15 skin tags 11200

Skin tag removal is a simple procedure where small, benign growths on the skin are carefully removed. This can be achieved through several methods such as freezing, burning, or cutting off the skin tags. The process is quick, typically painless with local anesthesia, and aids in skin smoothness.

14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95661 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.61 typical visit price

range $60.44 – $180.85

Typical copayment $23.15 (range $15.11 – $45.21)

Most-billed visit code 99203

Established Patient

$75.03 typical visit price

range $19.88 – $148.15

Typical copayment $18.75 (range $4.97 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.53/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

97.26

Promoting Interoperability

100

Improvement Activities

Cost

77.87

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLIVIA HOANG-KELADA M.D.

Pediatrics