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INNOVATIVE DERMATOLOGY ALLIANCE CA
NPI 1083188221
Dermatology in Visalia, CA

Active since January 21, 2019CLIA 05D0671853 · Certificate of Compliance
5530 AVENIDA DE LOS ROBLES, VISALIA, CA 93291(559) 733-5050 Get Directions Write a Review

NPPES record last updated: May 14, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 14, 2026, May 16, 2023, Jan 21, 2019 (3 updates tracked since 2019).

About Innovative Dermatology Alliance Ca NPPES

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

INNOVATIVE DERMATOLOGY ALLIANCE CA (NPI 1083188221), doing business as Peak Dermatology, is a healthcare organization registered as a dermatology in Visalia, California and active in the NPI registry since January 2019. The organization holds a CLIA Certificate of Compliance certificate valid through March 23, 2027 and lists Christopher Ugochukwu Ugorji Rex, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1083188221
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINNOVATIVE DERMATOLOGY ALLIANCE CA
Location Address5530 AVENIDA DE LOS ROBLESVisalia, CA 93291
Mailing Address13921 W Grand Ave Bldg ESurprise, AZ 85374-2439 · (559) 733-5050
Phone(559) 733-5050
Organization SubpartNo
Authorized OfficialChristopher Ugochukwu Ugorji RexOwner/provider · (904) 994-4533
Enumeration DateJanuary 21, 2019
Last NPPES UpdateMay 14, 20263 updates tracked since enumeration
NPPES CertifiedMay 14, 2026
✔ NPI 1083188221 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
5530 AVENIDA DE LOS ROBLES, Visalia, CA 93291
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Other Names 2

Doing Business AsPeak Dermatology
Doing Business AsPeak Dermatology Aesthetics And Wellness

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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)

Innovative Dermatology Alliance Ca is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

10

Medicare enrollment records show 10 clinicians reassign Medicare billing to Innovative Dermatology Alliance Ca, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Nurse Practitioner9
Dermatology1

Clinicians, nearest first (10)

Amanda Pacillas
Nurse Practitioner
NPI 1700409943
1136 N CHINOWTH ST
Visalia, CA 93291
(559) 671-0101
✔ PECOS✔ Accepts Medicare4.2 mi
Abbey Morren, FNP
Nurse Practitioner
NPI 1831749159
5400 W HILLSDALE AVE
Visalia, CA 93291
(559) 738-7500
✔ PECOS✔ Accepts Medicare4.4 mi
Sandeep Bhangoo, N.P
Nurse Practitioner
NPI 1265716542
5315 W HILLSDALE AVE
Visalia, CA 93291
(559) 732-9900
✔ PECOS✔ Accepts Medicare4.5 mi
Farnoush Karimpour, FNP-BC
Nurse Practitioner
NPI 1902248859
2611 N DINUBA BLVD
Visalia, CA 93291
(559) 623-0700
✔ PECOS✔ Accepts Medicare5.0 mi
April Matthews, FNP
Nurse Practitioner
NPI 1992267389
400 W MINERAL KING AVE
Visalia, CA 93291
(559) 624-2017
✔ PECOS✔ Accepts Medicare6.2 mi
Katelyn Giannandrea, FNP
Nurse Practitioner
NPI 1538524749
460 GREENFIELD AVE STE 3
Hanford, CA 93230
(559) 584-5770
✔ PECOS17 mi
Alfredo Lopez, NP
Nurse Practitioner
NPI 1891553913
135 W SHAW AVE
Fresno, CA 93704
(559) 258-0968
✔ PECOS✔ Accepts Medicare37 mi
Edgar Botello, NP
Nurse Practitioner
NPI 1376164210
6730 N WEST AVE
Fresno, CA 93711
(559) 439-3000
✔ PECOS✔ Accepts Medicare39 mi
Eric Vohs, APRN, FNP-C
Nurse Practitioner
NPI 1366101024
16838 E PALISADES BLVD STE 105
Fountain Hills, AZ 85268
(480) 660-4586
✔ PECOS✔ Accepts Medicare475 mi
Christopher Rex, M.D.
Dermatology
NPI 1083054571
127 E MAIN ST STE A
Payson, AZ 85541
(928) 951-0395
✔ PECOS✔ Accepts Medicare479 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D0671853

Innovative Dermatology Alliance Ca Dba Peak Dermatology Aesthetics And Wellness · Visalia, CA
Active · expires Mar 23, 2027
CLIA Number05D0671853
Laboratory TypePhysician Office
Certificate Effective DateMarch 24, 2025
Certificate Expiration DateMarch 23, 2027
Laboratory DirectorChristopher U. Rex
Laboratory Phone(559) 733-5050
Laboratory LocationInnovative Dermatology Alliance Ca Dba Peak Dermatology Aesthetics And Wellness5530 W Avenida De Los Robles, Visalia, CA 93291
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Innovative Dermatology Alliance Ca's NPI number?

The NPI number for Innovative Dermatology Alliance Ca is 1083188221. It was assigned to this organization in the NPPES registry on January 21, 2019. The provider is doing business as Peak Dermatology and Peak Dermatology Aesthetics and Wellness.

Where is Innovative Dermatology Alliance Ca located?

Innovative Dermatology Alliance Ca is located at 5530 Avenida De Los Robles, Visalia, CA 93291. The listed phone number is (559) 733-5050.

What is Innovative Dermatology Alliance Ca's specialty?

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

Is Innovative Dermatology Alliance Ca enrolled in Medicare?

Yes. Innovative Dermatology Alliance Ca is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Innovative Dermatology Alliance Ca?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 2 Medicare specialties reassign their Medicare billing to Innovative Dermatology Alliance Ca. 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. The largest specialties are Nurse Practitioner (9) and Dermatology (1). Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Innovative Dermatology Alliance Ca hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0671853) is associated with this NPI, valid through March 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Innovative Dermatology Alliance Ca was last updated on May 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.